NPIMap

Organization Active NPI

Northland Medical Transport

  • Non-emergency Medical Transport (VAN)
  • Pearson, WI
National Provider Identifier
1679775332
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Legal business name
NORTHLAND MEDICAL TRANSPORT
Practice address
N11106 E Shore Rd
Pearson, WI 54462-8224
Phone
(715) 484-2503
NPI assigned
Jun 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jocelyn Bruckert
Title
Partner
Phone
(715) 484-2503

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X WI Primary

Addresses

Primary practice location

N11106 E Shore Rd
Pearson, WI 54462-8224

Mailing address

N11106 E Shore Rd
Pearson, WI 54462-8224
Phone (715) 484-2503

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679775332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N11106 E SHORE RD",
            "city": "PEARSON",
            "state": "WI",
            "postal_code": "544628224",
            "telephone_number": "715-484-2503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N11106 E SHORE RD",
            "city": "PEARSON",
            "state": "WI",
            "postal_code": "544628224",
            "telephone_number": "715-484-2503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLAND MEDICAL TRANSPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRUCKERT",
        "authorized_official_first_name": "JOCELYN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "715-484-2503"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.