Cornell Area Ambulance Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

CORNELL AREA AMBULANCE SERVICE

Practice address

412 S 3Rd St
Cornell, WI 54732-8303

Phone

(715) 239-3346

NPI assigned

Oct 17, 2007

Organization subpart

No

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

Authorized official

Name

Amy J. Clark

Title

Operations Manager

Phone

(715) 828-1258

Specialties & licenses 1

Addresses

Other identifiers 1

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

Locations

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1659560449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3",
            "city": "CORNELL",
            "state": "WI",
            "postal_code": "547320003",
            "telephone_number": "715-239-3346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 S 3RD ST",
            "city": "CORNELL",
            "state": "WI",
            "postal_code": "547328303",
            "telephone_number": "715-239-3346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNELL AREA AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-17",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "715-828-1258"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41324900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kim Bergh, PTA
• Janis Cekan, APNP
• Cornell Chiropractic, LLC
• Cornell Pharmacy, Inc.
• Cornell School District
• Alicia Hartung Duerst, DPT
• Extendicare Homes, Inc.

• All providers in Cornell, WI
• Land Ambulance in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.