Kennard Volunteer Fire Rescue Squad

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1167 Issued in NE

Legal business name

KENNARD VOLUNTEER FIRE RESCUE SQUAD

Practice address

208 Main
Kennard, NE 68034

Phone

(877) 218-4392

Fax

(877) 343-0131

NPI assigned

Feb 13, 2007

Last updated

Jun 6, 2023By 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

Kylee Maree Nielsen

Title

Emt

Phone

(402) 533-3596

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NE

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": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686009600000",
    "number": "1275675365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10802 FARNAM DR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681543237",
            "telephone_number": "531-895-5853",
            "fax_number": "877-343-0131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 MAIN",
            "city": "KENNARD",
            "state": "NE",
            "postal_code": "68034",
            "telephone_number": "877-218-4392",
            "fax_number": "877-343-0131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNARD VOLUNTEER FIRE RESCUE SQUAD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A",
        "authorized_official_last_name": "NIELSEN",
        "authorized_official_first_name": "KYLEE",
        "authorized_official_middle_name": "MAREE",
        "authorized_official_title_or_position": "EMT",
        "authorized_official_telephone_number": "402-533-3596"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NE",
            "license": "1167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025044000",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PROVIDER NO",
            "identifier": "590012703",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NO",
            "identifier": "39423",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Makendra Marie Kellogg
• Rebecca S Manzer

• Land Ambulance in Kennard, NE
• Providers in Kennard, NE by specialty
• Land Ambulance in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; 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.