Minong Area Fire and Ambulance Service

Primary specialty

Emergency Care Clinic/CenterTaxonomy code 261QE0002X

License

6000164 Issued in WI

Legal business name

MINONG AREA FIRE AND AMBULANCE SERVICE

Doing business as

Minong Area Ambulance Service

Practice address

123 5TH Ave E
Minong, WI 54859-9541

Phone

(715) 466-2322

NPI assigned

May 17, 2007

Last updated

Mar 21, 2024By 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

Janel Lee

Title

Clerk Administrator

Phone

(715) 466-2322

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Minong Area Ambulance Service Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710979200000",
    "number": "1235346297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 5TH AVE",
            "city": "MINONG",
            "state": "WI",
            "postal_code": "548599541",
            "telephone_number": "715-466-2322",
            "fax_number": "715-466-4752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 5TH AVE E",
            "city": "MINONG",
            "state": "WI",
            "postal_code": "548599541",
            "telephone_number": "715-466-2322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINONG AREA FIRE AND AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JANEL",
        "authorized_official_title_or_position": "CLERK ADMINISTRATOR",
        "authorized_official_telephone_number": "715-466-2322"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "WI",
            "license": "6000164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41332400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Minong Area Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebecca Keith, F.N.P.
• Frederick D Kosmach, PA-C
• Northwood School District
• Heather L Runge, PA-C
• Richard R Scott Jr., LAC
• The Lakes Community Health Center, Inc (Northlakes Community Clinic)
• The Lakes Community Health Center, Inc (Northlakes Clinic Pharmacy)

• Emergency Care Clinic/Center in Minong, WI
• Providers in Minong, 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 Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.