Village North Fond Du Lac

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

VILLAGE NORTH FOND DU LAC

Doing business as

North Fond du Lac EMS

Practice address

16 Garfield St
North Fond Du Lac, WI 54937-1387

Phone

(920) 929-3954

NPI assigned

May 20, 2006

Organization subpart

No

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

Authorized official

Name

Jake Flaherty

Title

Fire Chief

Phone

(920) 929-3765

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• North Fond du Lac EMS 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": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775088000000",
    "number": "1700830973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6253",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601976253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 GARFIELD ST",
            "city": "NORTH FOND DU LAC",
            "state": "WI",
            "postal_code": "549371387",
            "telephone_number": "920-929-3954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE NORTH FOND DU LAC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A",
        "authorized_official_last_name": "FLAHERTY",
        "authorized_official_first_name": "JAKE",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "920-929-3765"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN'S PLUS",
            "identifier": "1022683",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41327400",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVOCARE",
            "identifier": "000082921",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH PLAN",
            "identifier": "1962",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "WI0101",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Fond du Lac EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephanie L Simon
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• Danny Trevor Walker, DO
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• Bryce Zdanovec, DPT

• Land Ambulance in North Fond Du Lac, WI
• Providers in North Fond Du Lac, WI by specialty
• Land Ambulance in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2026; 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.