City of Portage

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

CITY OF PORTAGE

Doing business as

City of Portage EMS

Practice address

119 W Pleasant St
Portage, WI 53901-1742

Phone

(608) 742-2172

NPI assigned

Aug 7, 2024

Last updated

Dec 12, 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

Cody Doucette

Title

EMS Captain

Phone

(608) 566-8270

Specialties & licenses 1

Addresses

Other names 1

• City of Portage 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": "1722988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733961600000",
    "number": "1396575817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 W PLEASANT ST",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539011742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 W PLEASANT ST",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539011742",
            "telephone_number": "608-742-2172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF PORTAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-07",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A",
        "authorized_official_last_name": "DOUCETTE",
        "authorized_official_first_name": "CODY",
        "authorized_official_title_or_position": "EMS CAPTAIN",
        "authorized_official_telephone_number": "608-566-8270"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "City of Portage EMS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "City of Portage EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Diana L Charlebois, MSN-FNP
• Soumen Chatterjee, DDS
• Ericka Chavez, PTA
• Charisa Marie Cheek, OTR
• Derek John Ciecko, OTR
• Columbia Correctional Institution (Cci)
• Columbia County HHSD
• Columbia County HHSD
• Columbia County HHSD
• Columbia County HHSD

• Land Ambulance in Portage, WI
• Providers in Portage, 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 12, 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.