NPIMap

Organization Active NPI

City of Glenwood City

Doing business as Glenwood City Ambulance Department

  • Land Ambulance
  • Glenwood City, WI
National Provider Identifier
1588736482
Registry record updated May 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
6000572 Issued in WI
Legal business name
CITY OF GLENWOOD CITY
Doing business as
Glenwood City Ambulance Department
Practice address
10 Misty Lane
Glenwood City, WI 54013
Phone
(715) 265-4227
Fax
(715) 265-7307
NPI assigned
Nov 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2008

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

Authorized official

Name
Tracey A. Schone
Title
Ambulance Administrator
Phone
(715) 265-4227

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 6000572 WI
Land Ambulance 3416L0300X 6000572 WI Primary

Addresses

Primary practice location

10 Misty Lane
Glenwood City, WI 54013

Mailing address

132 Pine St.
PO Box 368
Glenwood City, WI 54013
Phone (715) 265-4227

Other identifiers 1

IdentifierTypeStateIssuer
60572OtherWIAMBULANCE PROVIDER NUMBER

Other names 1

  • Glenwood City Ambulance Department Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080613000592 WI Part B Supplier - Ambulance Service Supplier 4688745920 Practice locations: Glenwood City, WI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211500800000",
    "number": "1588736482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 PINE ST.",
            "address_2": "PO BOX 368",
            "city": "GLENWOOD CITY",
            "state": "WI",
            "postal_code": "54013",
            "telephone_number": "715-265-4227",
            "fax_number": "715-265-7307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MISTY LANE",
            "city": "GLENWOOD CITY",
            "state": "WI",
            "postal_code": "54013",
            "telephone_number": "715-265-4227",
            "fax_number": "715-265-7307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF GLENWOOD CITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2008-05-23",
        "status": "A",
        "authorized_official_last_name": "SCHONE",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "AMBULANCE ADMINISTRATOR",
        "authorized_official_telephone_number": "715-265-4227"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "WI",
            "license": "6000572",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WI",
            "license": "6000572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMBULANCE PROVIDER NUMBER",
            "identifier": "60572",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glenwood City Ambulance Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glenwood City, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.