City of Wahoo

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

CITY OF WAHOO

Practice address

158 W 6TH St
Wahoo, NE 68066-1647

Phone

(877) 218-4392

Fax

(877) 343-0131

NPI assigned

Oct 19, 2005

Organization subpart

No

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

Authorized official

Name

Grant Anderson

Title

Director of EMS

Phone

(402) 217-8606

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• WAHOO RESCUE SQUAD Doing business as

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Locations

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682035200000",
    "number": "1477542645",
    "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": "877-218-4392",
            "fax_number": "877-343-0131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 W 6TH ST",
            "city": "WAHOO",
            "state": "NE",
            "postal_code": "680661647",
            "telephone_number": "877-218-4392",
            "fax_number": "877-343-0131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF WAHOO",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-19",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "GRANT",
        "authorized_official_title_or_position": "DIRECTOR OF EMS",
        "authorized_official_telephone_number": "402-217-8606"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025282400",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NE. STATE LICENSE",
            "identifier": "5138",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NO",
            "identifier": "09409",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WAHOO RESCUE SQUAD",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WAHOO RESCUE SQUAD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anna Cedfeldt
• Barbara Chall
• Joan Chapman
• Abigail Kay Chase, APRN
• Keith Robert Chvatal, DC
• Payton Conrad
• CRMT Inc
• CRMT Inc
• CRMT Inc.
• Cameron Curtis

• All providers in Wahoo, NE
• Land Ambulance in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2023; 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.