City of Evansville

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

CITY OF EVANSVILLE

Practice address

31 S Madison St
Evansville, WI 53536-1317

Phone

(608) 882-2269

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

Mary Beaver

Title

Coordinator

Phone

(608) 882-2269

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Evansville EMS Doing business as

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": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1376597922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 76",
            "city": "EVANSVILLE",
            "state": "WI",
            "postal_code": "535360076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 S MADISON ST",
            "city": "EVANSVILLE",
            "state": "WI",
            "postal_code": "535361317",
            "telephone_number": "608-882-2269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF EVANSVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "BEAVER",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "COORDINATOR",
        "authorized_official_telephone_number": "608-882-2269"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41352000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evansville EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Allison Rae Becker, N.D., LAC
• Hailey Bomar, DPT
• Anna Fedak Botts, D.M.D.
• Sarah Ann Burd
• Ashley Nicole Carrington, DPT
• Frances Coan-Meredith, LPC
• Susan Dooley Conaway
• Core Physical Therapy, LLC
• Dean Health Systems, Inc.
• Evansville Community School District

• All providers in Evansville, WI
• Land Ambulance in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.