Brodhead Area Emergency Medical

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

BRODHEAD AREA EMERGENCY MEDICAL

Practice address

1003 12TH St
Brodhead, WI 53520-1535

Phone

(608) 897-4092

NPI assigned

May 19, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bryan Niedermeier

Title

Captain

Phone

(608) 897-4092

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Brodhead Area EMS 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": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356912000000",
    "number": "1366495269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14",
            "city": "BRODHEAD",
            "state": "WI",
            "postal_code": "535200014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 12TH ST",
            "city": "BRODHEAD",
            "state": "WI",
            "postal_code": "535201535",
            "telephone_number": "608-897-4092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRODHEAD AREA EMERGENCY MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2012-12-31",
        "status": "A",
        "authorized_official_last_name": "NIEDERMEIER",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "CAPTAIN",
        "authorized_official_telephone_number": "608-897-4092"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN'S PLUS",
            "identifier": "1019784",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIRSP",
            "identifier": "41345900",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41345900",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVOCARE MCHMO",
            "identifier": "000081269",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "WI0100",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brodhead Area EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Darcey Jo Bedward, FNP APNP
• Kevin M Bluemel, MD
• Alyssa Marie Bolly, R.N.
• Jennifer Ellen Brady, R.N.
• Daniel R Branson, D.D.S.
• Brodhead Chiropractic Center LLC
• Brodhead Chiropractic Center, LLC
• Brodhead Family Chiropractic LLC
• Brodhead Vision Clinic, Inc
• Cheryl Buroker

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2012; 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.