Village of Walworth

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

VILLAGE OF WALWORTH

Doing business as

Walworth Fire & Rescue

Practice address

247 N Main St
Walworth, WI 53184-9781

Phone

(262) 275-3838

NPI assigned

May 19, 2006

Last updated

Jan 16, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David Austin

Title

Fire Chief

Phone

(262) 275-3838

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Walworth Fire & Rescue Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1144273012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "WALWORTH",
            "state": "WI",
            "postal_code": "531840400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "247 N MAIN ST",
            "city": "WALWORTH",
            "state": "WI",
            "postal_code": "531849781",
            "telephone_number": "262-275-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF WALWORTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "262-275-3838"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVOCARE MCHMO",
            "identifier": "000080021",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIRSP",
            "identifier": "41359900",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41359900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walworth Fire & Rescue",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Catie Fern Pontel, PTA
• Powerback Rehabilitation LLC (Powerback Rehabilitation)
• Daniel William Rankin
• Lindsey E Tuntland, MD
• Jennifer L Van Vleet, RN
• Walworth Elementary School
• Isabelle Wangerin
• Carol Anne Weikel, R.N.
• Glenn Alan Wergin, DMD
• WSSH Powerback Rehabilitation Services, LLC

• Land Ambulance in Walworth, WI
• Providers in Walworth, WI by specialty
• Land Ambulance in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.