Interstate EMS of Prairie Du Chien, Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

6001361 Issued in WI

Legal business name

INTERSTATE EMS OF PRAIRIE DU CHIEN, INC.

Practice address

1109 S 13TH St
Prairie Du Chien, WI 53821-2526

Phone

(608) 326-5422

NPI assigned

Apr 13, 2006

Last updated

Aug 30, 2010By 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

Delores Kussmaul

Title

Emt-Intermediate

Phone

(608) 326-5422

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283126400000",
    "number": "1205890621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 179",
            "city": "PRAIRIE DU CHIEN",
            "state": "WI",
            "postal_code": "538210179",
            "telephone_number": "608-326-5422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 S 13TH ST",
            "city": "PRAIRIE DU CHIEN",
            "state": "WI",
            "postal_code": "538212526",
            "telephone_number": "608-326-5422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERSTATE EMS OF PRAIRIE DU CHIEN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-13",
        "last_updated": "2010-08-30",
        "status": "A",
        "authorized_official_last_name": "KUSSMAUL",
        "authorized_official_first_name": "DELORES",
        "authorized_official_title_or_position": "EMT-INTERMEDIATE",
        "authorized_official_telephone_number": "608-326-5422"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WI",
            "license": "6001361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41353500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Calvin Hill, PHARMD
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• Kelsey M Huber, RPH
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• Dixie L Jackson, LPC
• Alexa Marie Jacobsen, FNP
• Paul F Johnston, PTA
• James C Jordan, MD

• Land Ambulance in Prairie Du Chien, WI
• Providers in Prairie Du Chien, WI by specialty
• Land Ambulance in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2010; 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.