Decatur Rural Fire Dept.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

DECATUR RURAL FIRE DEPT.

Doing business as

Decatur Vol. Fire and Rescue

Practice address

1012 S Broadway St
Decatur, NE 68020-2095

Phone

(402) 572-4019

Fax

(402) 965-8594

NPI assigned

Oct 21, 2005

Last updated

Feb 12, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kylea Punke

Title

Rescue Captain

Phone

(402) 313-9023

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• DECATUR VOL. FIRE AND RESCUE Doing business as

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707696000000",
    "number": "1669461653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 641880",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681647880",
            "telephone_number": "402-572-4019",
            "fax_number": "402-965-8594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 S BROADWAY ST",
            "city": "DECATUR",
            "state": "NE",
            "postal_code": "680202095",
            "telephone_number": "402-572-4019",
            "fax_number": "402-965-8594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR RURAL FIRE DEPT.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-21",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A",
        "authorized_official_last_name": "PUNKE",
        "authorized_official_first_name": "KYLEA",
        "authorized_official_title_or_position": "RESCUE CAPTAIN",
        "authorized_official_telephone_number": "402-313-9023"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SQUAD LICENSE",
            "identifier": "1091",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NO",
            "identifier": "09304",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025095200",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DECATUR VOL. FIRE AND RESCUE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Burgess Health Center (Burgess Family Clinic - Decatur)
• Marlene Graham
• Stephanie Neary
• Marcia Rae Pickell
• Hailey Rebecca Wolf
• Jessica Lynn Wolf

• Land Ambulance in Decatur, NE
• Providers in Decatur, NE by specialty
• Land Ambulance in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.