NPIMap

Organization Active NPI

Sullivan EMS LTD

  • Land Ambulance
  • Sullivan, WI
National Provider Identifier
1194831396
Registry record updated Oct 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
SULLIVAN EMS LTD
Practice address
802 Pleasant St
Sullivan, WI 53178-9764
Phone
(262) 593-2333
NPI assigned
Aug 21, 2006
Last updated
Oct 10, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2007

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

Authorized official

Name
Mr. David SulikNPI 1760602072
Title
Billing Manager
Phone
(262) 375-9610

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X NU Primary

Addresses

Primary practice location

802 Pleasant St
Sullivan, WI 53178-9764

Mailing address

PO Box 72140
Cedarburg, WI 53012-7340
Phone (262) 375-9610

Other identifiers 1

IdentifierTypeStateIssuer
41360600MedicaidWI

National Provider Directory

National Provider Directory

Locations

912 Front St
#A
Sullivan, WI 53178
Phone (262) 593-2235

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191974400000",
    "number": "1194831396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 72140",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530127340",
            "telephone_number": "262-375-9610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 PLEASANT ST",
            "city": "SULLIVAN",
            "state": "WI",
            "postal_code": "531789764",
            "telephone_number": "262-593-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SULLIVAN EMS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-10-10",
        "status": "A",
        "authorized_official_last_name": "SULIK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "262-375-9610",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41360600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sullivan, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.