Mishicot Area Ambulance Service, Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

601234 Issued in WI

Legal business name

MISHICOT AREA AMBULANCE SERVICE, INC.

Practice address

214 South Main Street
Mishicot, WI 54228

Phone

(920) 255-4235

Fax

(920) 755-2345

NPI assigned

Feb 28, 2007

Last updated

Sep 25, 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

Kristy E Reynolds

Title

Service Director

Phone

(920) 255-4235

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": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1255468955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 214",
            "city": "MISHICOT",
            "state": "WI",
            "postal_code": "542280214",
            "telephone_number": "920-255-4235",
            "fax_number": "920-755-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 SOUTH MAIN STREET",
            "city": "MISHICOT",
            "state": "WI",
            "postal_code": "54228",
            "telephone_number": "920-255-4235",
            "fax_number": "920-755-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISHICOT AREA AMBULANCE SERVICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "SERVICE DIRECTOR",
        "authorized_official_telephone_number": "920-255-4235"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WI",
            "license": "601234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41309700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heidi M. D. Griffey
• Ashley C Hines-Wilhelm, RN
• Kathryn Marie Kronforst, CRNA
• Erin Lasslo, DDS
• Ronald John Lese, DDS
• Mishicot Dental
• Mishicot School District
• Ashley Pfund
• Kevin J Schmitz
• Cathryn Schmoll

• Land Ambulance in Mishicot, WI
• Providers in Mishicot, WI by specialty
• Land Ambulance in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.