Fox Lake Community Fire Association

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

6000139 Issued in WI

Legal business name

FOX LAKE COMMUNITY FIRE ASSOCIATION

Practice address

246 E State St
Fox Lake, WI 53933-8027

Phone

(920) 928-6115

NPI assigned

May 30, 2006

Last updated

Jun 9, 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

Mr. Russell Kottke

Title

Secretary Treasurer

Phone

(920) 960-7754

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749427200000",
    "number": "1184671448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W8542 LAUREL HILL RD",
            "city": "FOX LAKE",
            "state": "WI",
            "postal_code": "539339739",
            "telephone_number": "920-928-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 E STATE ST",
            "city": "FOX LAKE",
            "state": "WI",
            "postal_code": "539338027",
            "telephone_number": "920-928-6115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOX LAKE COMMUNITY FIRE ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-30",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A",
        "authorized_official_last_name": "KOTTKE",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "SECRETARY TREASURER",
        "authorized_official_telephone_number": "920-960-7754",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WI",
            "license": "6000139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "H.I.R.S.P.",
            "identifier": "41314800",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WISCONSIN RENAL PROGRAM",
            "identifier": "41314800",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41314800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Comfortably Human Wellness
• Consultants Laboratory of Wisconsin, LLC
• Teresa Cramer-McDonald, NP,APNP
• Stacy Dahlke, LPC
• Amy Denneau, NP
• Cindy B Hankes, MD
• Charles E Larson, M.D.
• Craig Edward Mahlum, D.D.S.
• Megan A Schraufnagel
• Amanda Williams

• Land Ambulance in Fox Lake, WI
• Providers in Fox Lake, WI by specialty
• Land Ambulance in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.