Village of Johnson Creek

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

VILLAGE OF JOHNSON CREEK

Doing business as

Johnson Creek Fire & EMS Department

Practice address

120 S Watertown St
Johnson Creek, WI 53038-9510

Phone

(920) 699-5258

NPI assigned

Aug 19, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Tim Whitham

Title

Fire Chief

Phone

(920) 699-3456

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Johnson Creek Fire & EMS Department 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

Tax ID family

Johnson Creek Fire EMS Dept2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Johnson Creek Fire EMS Dept.

  • Land Ambulance
  • Johnson Creek, WI
  • NPI 1609933001
  NPD tax ID

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266278400000",
    "number": "1528172905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 529",
            "address_2": "120 SOUTH WATERTOWN STREET",
            "city": "JOHNSON CREEK",
            "state": "WI",
            "postal_code": "530380529",
            "telephone_number": "920-699-3456",
            "fax_number": "920-699-3458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S WATERTOWN ST",
            "city": "JOHNSON CREEK",
            "state": "WI",
            "postal_code": "530389510",
            "telephone_number": "920-699-5258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF JOHNSON CREEK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2010-02-16",
        "status": "A",
        "authorized_official_last_name": "WHITHAM",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "920-699-3456",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41307600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "519077",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Johnson Creek Fire & EMS Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberly D Turner, DC
• University of Wisconsin Medical Foundation Inc
• Guillermo Miguel Valenzuela Cortez, MD
• Jenell Lynn Valenzuela, APNP
• Kim Vetuschi
• Watertown Regional Medical Center Inc
• Watertown Regional Medical Center, Inc
• Lyndsey Webster, M.S. CCC-SLP
• Tory Lee Wetter, NP
• Ladd E. White, CSAC AND LPC

• Land Ambulance in Johnson Creek, WI
• Providers in Johnson Creek, 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 16, 2010; 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.