Active NPI
Pardeeville District Ambulance Service
- Land Ambulance
- Pardeeville, WI
National Provider Identifier
1629176649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- Legal business name
- PARDEEVILLE DISTRICT AMBULANCE SERVICE
- Practice address
- 501 Gillette St
Pardeeville, WI 53954 - Phone
- (608) 429-9089
- NPI assigned
- Sep 21, 2006
- Last updated
- Mar 24, 2020
- 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
- Linda Rae Henning, AEMT
- Title
- Director
- Phone
- (608) 429-9089
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | 6001377 | WI | |
| Land Ambulance | 3416L0300X | NU | Primary |
Addresses
Primary practice location
501 Gillette St
Pardeeville, WI 53954
Mailing address
PO Box 396
Pardeeville, WI 53954-0396
Phone (608) 429-9089
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41356600 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061211000113 | WI | Part B Supplier - Ambulance Service Supplier | 3274532726 | Practice locations: Pardeeville, WI |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1585008000000",
"number": "1629176649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 396",
"city": "PARDEEVILLE",
"state": "WI",
"postal_code": "539540396",
"telephone_number": "608-429-9089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 GILLETTE ST",
"city": "PARDEEVILLE",
"state": "WI",
"postal_code": "53954",
"telephone_number": "608-429-9089"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PARDEEVILLE DISTRICT AMBULANCE SERVICE",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-21",
"last_updated": "2020-03-24",
"certification_date": "2020-03-24",
"status": "A",
"authorized_official_last_name": "HENNING",
"authorized_official_first_name": "LINDA",
"authorized_official_middle_name": "RAE",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "608-429-9089",
"authorized_official_credential": "AEMT"
},
"taxonomies": [
{
"code": "341600000X",
"taxonomy_group": "",
"desc": "Ambulance",
"state": "WI",
"license": "6001377",
"primary": false
},
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "41356600",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pardeeville, WI
- Sara Beth McChesney, MSW
- MD Group II LLC (Pardeeville Hometown Pharmacy)
- MD Group II LLC (Pardeeville Hometown Pharmacy LTC)
- Lori Lynne Ortner, M.S. CCC-SLP
- Pardeeville Area School District
- Dawn Marie Paskey, RN
- Jennifer D Powers, M.A.
- Ryan's Expedited Stretcher Transport Transit LLC
- Virginia G Scott, DDS
- Janette Sheeks, RN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2020; 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.