Erickson-Nelson Services, Inc

Primary specialty

AmbulanceTaxonomy code 341600000X

License

6000405 Issued in WI

Legal business name

ERICKSON-NELSON SERVICES, INC

Doing business as

Erickson Ambulance

Practice address

826 S Memorial Dr
Racine, WI 53403-1339

Phone

(262) 632-5412

Fax

(262) 632-0532

NPI assigned

Nov 22, 2006

Last updated

Sep 23, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

ERICKSON-NELSON SERVICES, INCAs reported in NPPES

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

Authorized official

Name

Mr. Allen David Nelson

Title

Pres Ceo

Phone

(262) 632-5412

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ERICKSON AMBULANCE Doing business as

Part of

Erickson-Nelson Services Inc

Locations

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222128000000",
    "number": "1639244601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 S MEMORIAL DR",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031339",
            "telephone_number": "262-632-5412",
            "fax_number": "262-632-0532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 S MEMORIAL DR",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031339",
            "telephone_number": "262-632-5412",
            "fax_number": "262-632-0532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERICKSON-NELSON SERVICES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ERICKSON-NELSON SERVICES, INC",
        "enumeration_date": "2006-11-22",
        "last_updated": "2008-09-23",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRES CEO",
        "authorized_official_telephone_number": "262-632-5412",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "WI",
            "license": "6000405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41320700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ERICKSON AMBULANCE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulance in Racine, WI
• Providers in Racine, WI by specialty
• Ambulance in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.