Organization Active NPI

Spencer Area Fire and Ambulance Commission

Doing business as Spencer Fire Department and Ambulance Service

  • Ambulance
  • Spencer, WI
National Provider Identifier
1164552105
Registry record updated Mar 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
94083 Issued in WI
Legal business name
SPENCER AREA FIRE AND AMBULANCE COMMISSION
Doing business as
Spencer Fire Department and Ambulance Service
Practice address
206 W Willow Drive
206 W Willow Drive
Spencer, WI 54479-9552
Phone
(715) 659-4030
Fax
(715) 659-4106
NPI assigned
Mar 7, 2007
Last updated
Mar 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2025

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

Authorized official

Name
Daniel Wall
Title
3Rd Assistant Chief
Phone
(715) 615-9596

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 94083 WI Primary

Addresses

Primary practice location

206 W Willow Drive
206 W Willow Drive
Spencer, WI 54479-9552

Mailing address

PO Box 360
206 W Willow Drive
Spencer, WI 54479-9552
Phone (715) 659-4030

Other names 1

  • Spencer Fire Department and Ambulance Service Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120523000609 WI Part B Supplier - Ambulance Service Supplier 4587827837 Practice locations: Spencer, WI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D0985188Spencer Area Ambulance206 E Willow Dr, Spencer, WI 54479Certificate of waiverApr 9, 2027

National Provider Directory

National Provider Directory

Locations

206 W Willow Dr
206 W Willow Dr
Spencer, WI 54479
Phone (715) 659-4030

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741478400000",
    "number": "1164552105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 360",
            "address_2": "206 W WILLOW DRIVE",
            "city": "SPENCER",
            "state": "WI",
            "postal_code": "544799552",
            "telephone_number": "715-659-4030",
            "fax_number": "715-659-4106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 W WILLOW DRIVE",
            "address_2": "206 W WILLOW DRIVE",
            "city": "SPENCER",
            "state": "WI",
            "postal_code": "544799552",
            "telephone_number": "715-659-4030",
            "fax_number": "715-659-4106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPENCER AREA FIRE AND AMBULANCE COMMISSION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2025-03-09",
        "certification_date": "2025-03-09",
        "status": "A",
        "authorized_official_last_name": "WALL",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "3RD ASSISTANT CHIEF",
        "authorized_official_telephone_number": "715-615-9596"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "WI",
            "license": "94083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spencer Fire Department and Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spencer, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.