Active NPI
City of Fond Du Lac
Doing business as City of Fond du Lac Fire Deparment
- Land Ambulance
- Fond Du Lac, WI
National Provider Identifier
1619025889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 6000344
- Legal business name
- CITY OF FOND DU LAC
- Doing business as
- City of Fond du Lac Fire Deparment
- Practice address
- 815 S Main St
Fond Du Lac, WI 54935-5738 - Phone
- (920) 322-3800
- NPI assigned
- Jan 6, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tricia Davi
- Title
- Director of Administration
- Phone
- (920) 322-3455
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 6000344 | WI | Primary |
Addresses
Primary practice location
815 S Main St
Fond Du Lac, WI 54935-5738
Mailing address
160 S Macy St
PO Box 150
Fond Du Lac, WI 54935-4241
Phone (920) 322-3400
Other names 1
- City of Fond du Lac Fire Deparment
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081118000253 | WI | Part B Supplier - Ambulance Service Supplier | 3072673250 | Practice locations: Fond Du Lac, WI |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D1008743 | City of Fond Du Lac Fire Rescue | Certificate of waiver | Jan 26, 2027 |
National Provider Directory
National Provider DirectoryLocations
235 S National Ave
Fond du Lac, WI 54935
Phone (920) 322-3454
815 S Main St
Fond du Lac, WI 54935
Phone (920) 322-3454
855 Western Ave
Fond du Lac, WI 54935
Phone (920) 322-3454
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168041600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788912000000",
"number": "1619025889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "160 S MACY ST",
"address_2": "PO BOX 150",
"city": "FOND DU LAC",
"state": "WI",
"postal_code": "549354241",
"telephone_number": "920-322-3400",
"fax_number": "336-510-5894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "815 S MAIN ST",
"city": "FOND DU LAC",
"state": "WI",
"postal_code": "549355738",
"telephone_number": "920-322-3800"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CITY OF FOND DU LAC",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-06",
"last_updated": "2026-09-09",
"certification_date": "2026-09-09",
"status": "A",
"authorized_official_last_name": "DAVI",
"authorized_official_first_name": "TRICIA",
"authorized_official_title_or_position": "DIRECTOR OF ADMINISTRATION",
"authorized_official_telephone_number": "920-322-3455"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "WI",
"license": "6000344",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "City of Fond du Lac Fire Deparment",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Fond Du Lac, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; 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.