City of Dodgeville

Primary specialty

Intermediate Emergency Medical TechnicianTaxonomy code 146M00000X

License

60 01312 Issued in WI

Legal business name

CITY OF DODGEVILLE

Doing business as

Dodgeville Area Ambulance Service

Practice address

100 E Fountain St
Dodgeville, WI 53533-1750

Phone

(608) 935-5111

Fax

(608) 935-9477

NPI assigned

May 30, 2006

Organization subpart

No

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

Authorized official

Name

Brian Cushman, EMT I

Title

Chief

Phone

(608) 935-5111

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dodgeville Area Ambulance Service Doing business as

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": "1148947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357171200000",
    "number": "1700833167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2715 W FRANK ST",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547032593",
            "fax_number": "715-834-5870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E FOUNTAIN ST",
            "city": "DODGEVILLE",
            "state": "WI",
            "postal_code": "535331750",
            "telephone_number": "608-935-5111",
            "fax_number": "608-935-9477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF DODGEVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-30",
        "last_updated": "2013-01-03",
        "status": "A",
        "authorized_official_last_name": "CUSHMAN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "608-935-5111",
        "authorized_official_credential": "EMT I"
    },
    "taxonomies": [
        {
            "code": "146M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medical Technician, Intermediate",
            "state": "WI",
            "license": "60 01312",
            "primary": true
        },
        {
            "code": "146N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medical Technician, Basic",
            "state": "WI",
            "license": "60 01312",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41345200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dodgeville Area Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sara Marie Bruckert
• Sharon Ann Burreson, PT
• Molly Callahan
• Bridget Ann Carter, RN
• Kiley Prusso Cates, RN
• Christine Cole
• Corner Drug Store, Inc
• Corner Drug Store, Inc
• Cornerstone Foundation
• County of Grant Dba Unified Community Services

• Intermediate Emergency Medical Technician in Dodgeville, WI
• Providers in Dodgeville, WI by specialty
• Intermediate Emergency Medical Technician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; 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.