Hatley Area Fire & Ambulance District

Primary specialty

Emergency Care Clinic/CenterTaxonomy code 261QE0002X

License

60-01379 Issued in WI

Legal business name

HATLEY AREA FIRE & AMBULANCE DISTRICT

Practice address

310 Clark St
Hatley, WI 54440-8704

Phone

(715) 446-2650

Fax

(715) 446-2241

NPI assigned

Sep 13, 2005

Last updated

Aug 22, 2020By 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

Mrs. Kathy Maves

Title

Office Manager

Phone

(715) 793-3333

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1126569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205821584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E MAIN ST",
            "city": "BOWLER",
            "state": "WI",
            "postal_code": "544169704",
            "telephone_number": "715-793-3333",
            "fax_number": "715-793-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 CLARK ST",
            "city": "HATLEY",
            "state": "WI",
            "postal_code": "544408704",
            "telephone_number": "715-446-2650",
            "fax_number": "715-446-2241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HATLEY AREA FIRE & AMBULANCE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAVES",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "715-793-3333",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "WI",
            "license": "60-01379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41357300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony Andraschko, RN
• Bonnie Sue Cabrera, REGISTERED NURSE
• Renee M Kolb, LPN
• Savanah Jo Vera Resch
• Theresa Stieber
• The Shield LLC.
• Wendy Vargas, CNA

• Emergency Care Clinic/Center in Hatley, WI
• Providers in Hatley, WI by specialty
• Emergency Care Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.