Village of Kewaskum

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

6000375 Issued in WI

Legal business name

VILLAGE OF KEWASKUM

Doing business as

Kewaskum Fire Department

Practice address

1106 Fond Du Lac Ave
Kewaskum, WI 53040-9492

Phone

(262) 626-2411

Fax

(262) 626-3635

NPI assigned

Feb 8, 2011

Organization subpart

No

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

Authorized official

Name

Michelle L Scherff Sulik

Title

Vice President

Phone

(262) 375-9610

Specialties & licenses 1

Addresses

Other names 1

• Kewaskum Fire Department Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

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

{
    "created_epoch": "1297123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297123200000",
    "number": "1396041448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 72140",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530127340",
            "telephone_number": "262-375-9610",
            "fax_number": "262-375-9608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 FOND DU LAC AVE",
            "city": "KEWASKUM",
            "state": "WI",
            "postal_code": "530409492",
            "telephone_number": "262-626-2411",
            "fax_number": "262-626-3635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF KEWASKUM",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-08",
        "last_updated": "2011-02-08",
        "status": "A",
        "authorized_official_last_name": "SCHERFF SULIK",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "262-375-9610"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WI",
            "license": "6000375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kewaskum Fire Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephen R. Van Ess, D.D.S., S.C.
• The Careing Hand LLC
• Nicole Shannon Thull, SAC-IT
• Chantelle M Toth, SLP
• Stephen Reynolds Van Ess, D.D.S.
• Amber Ann Webb
• Rachel Weber
• Hannah Carol Wedin, CCC, SLP
• Michelle Weiss, FNP-BC
• West Bend Clinic

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2011; 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.