Town of Long Lake

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

6604974 Issued in WI

Legal business name

TOWN OF LONG LAKE

Practice address

3348 Wisconsin 139
Long Lake, WI 54542

Phone

(715) 674-2263

NPI assigned

Feb 1, 2018

Last updated

Feb 1, 2018By 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

Jeff Kislewski

Title

Director

Phone

(717) 724-4136

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517443200000",
    "number": "1225536527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 138",
            "city": "LONG LAKE",
            "state": "WI",
            "postal_code": "545420138",
            "telephone_number": "715-674-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3348 WISCONSIN 139",
            "city": "LONG LAKE",
            "state": "WI",
            "postal_code": "54542",
            "telephone_number": "715-674-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN OF LONG LAKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-01",
        "last_updated": "2018-02-01",
        "status": "A",
        "authorized_official_last_name": "KISLEWSKI",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "717-724-4136"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WI",
            "license": "6604974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2018; 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.