Village of Bristol

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

6000385 Issued in WI

Legal business name

VILLAGE OF BRISTOL

Practice address

8301 198TH Ave
Bristol, WI 53104-9513

Phone

(262) 857-2711

Fax

(262) 857-2136

NPI assigned

Jan 21, 2010

Organization subpart

No

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

Authorized official

Name

Peter Parker

Title

Fire Chief

Phone

(262) 857-2711

Specialties & licenses 1

Addresses

Other names 1

• BRISTOL FIRE AND RESCUE Other name

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

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

{
    "created_epoch": "1264032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264032000000",
    "number": "1659602290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 457",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600900457",
            "telephone_number": "847-577-8811",
            "fax_number": "847-577-3518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 198TH AVE",
            "city": "BRISTOL",
            "state": "WI",
            "postal_code": "531049513",
            "telephone_number": "262-857-2711",
            "fax_number": "262-857-2136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF BRISTOL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-21",
        "last_updated": "2010-01-21",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "262-857-2711"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WI",
            "license": "6000385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BRISTOL FIRE AND RESCUE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Erika McCullough, LPN
• Dennette L. Scheckel, MHS, CCC/SLP/L
• Jean R Shannon
• Town of Bristol
• United Hospital System
• Nikki E Williams, LPN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2010; 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.