City of Seymour

Primary specialty

AmbulanceTaxonomy code 341600000X

License

6000322 Issued in WI

Legal business name

CITY OF SEYMOUR

Doing business as

Seymour Rescue Squad

Practice address

328 North Main Street
Seymour, WI 54165-1312

Phone

(920) 873-2209

NPI assigned

Mar 7, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Mary Gentile

Title

Authorized Agent

Phone

(800) 452-8191

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Seymour Rescue Squad Doing business as

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": "1141689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225929600000",
    "number": "1699742833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 290184",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061290184",
            "telephone_number": "800-452-8191",
            "fax_number": "860-563-3403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 NORTH MAIN STREET",
            "city": "SEYMOUR",
            "state": "WI",
            "postal_code": "541651312",
            "telephone_number": "920-873-2209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF SEYMOUR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-07",
        "last_updated": "2008-11-06",
        "status": "A",
        "authorized_official_last_name": "GENTILE",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "AUTHORIZED AGENT",
        "authorized_official_telephone_number": "800-452-8191",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "WI",
            "license": "6000322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41334400",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "791590522",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seymour Rescue Squad",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eric Daniel Bevers, DPT
• Catrina Anita Bhatty
• Jessie Boeckman, PHARMD
• Aubrey Buchholtz
• John Caldwell, R.PH.
• Kristin M Collar, APNP
• Lucy Deleeuw
• Kristen Diermeier, CCC-SLP
• Elizabeth Dwyer, PT
• Denise M Ellis, LAT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2008; 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.