NPIMap

Organization Active NPI

County of Portage

  • Land Ambulance
  • Stevens Point, WI
National Provider Identifier
1154438885
Registry record updated Nov 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
COUNTY OF PORTAGE
Doing business as
PORTAGE COUNTY AMBULANCE
Practice address
1516 Church St
Stevens Point, WI 54481-3501
Phone
(715) 346-1398
NPI assigned
Aug 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2014

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

Authorized official

Name
Paul R Baker
Title
Em/EMS Director
Phone
(715) 346-1265

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

1516 Church St
Stevens Point, WI 54481-3501

Mailing address

PO Box 457
Wheeling, IL 60090-0457
Phone (800) 244-2345

Other identifiers 1

IdentifierTypeStateIssuer
41323000MedicaidWI

Other names 1

  • PORTAGE COUNTY AMBULANCE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091021000024 WI Part B Supplier - Ambulance Service Supplier 7416843388 Practice locations: Amherst, WI; Plover, WI; Stevens Point, WI

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

  • County of Portage
    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Stevens Point, WI
    • NPI 1386720043

    7416843388

    Same PAC ID

National Provider Directory

National Provider Directory
Tax ID family
Portage Co Human Serv3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1516 Church St
Stevens Point, WI 54481
Phone (715) 346-1398

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414972800000",
    "number": "1154438885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 457",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600900457",
            "telephone_number": "800-244-2345",
            "fax_number": "800-329-5274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 CHURCH ST",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544813501",
            "telephone_number": "715-346-1398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF PORTAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2014-11-03",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "EM/EMS DIRECTOR",
        "authorized_official_telephone_number": "715-346-1265"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41323000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PORTAGE COUNTY AMBULANCE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stevens Point, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2014; 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.