Town of Lac Du Flambeau

Primary specialty

AmbulanceTaxonomy code 341600000X

License

6000703 Issued in WI

Legal business name

TOWN OF LAC DU FLAMBEAU

Practice address

614 Wild Rice Avenue
Lac Du Flambeau, WI 54538

Phone

(715) 588-3358

Fax

(715) 588-7923

NPI assigned

Aug 24, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Janet Lynn Bickelhaupt

Title

Deputy Town Clerk

Phone

(715) 588-3358

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lac du Flambeau Ambulance Service Other name

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": "1124841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720071723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 68",
            "city": "LAC DU FLAMBEAU",
            "state": "WI",
            "postal_code": "545380068",
            "telephone_number": "715-588-3358",
            "fax_number": "715-588-7923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 WILD RICE AVENUE",
            "city": "LAC DU FLAMBEAU",
            "state": "WI",
            "postal_code": "54538",
            "telephone_number": "715-588-3358",
            "fax_number": "715-588-7923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN OF LAC DU FLAMBEAU",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BICKELHAUPT",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "DEPUTY TOWN CLERK",
        "authorized_official_telephone_number": "715-588-3358",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "WI",
            "license": "6000703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41331000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lac du Flambeau Ambulance Service",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ann M Schmitz, RDH
• John Sargent Sholl, MD
• Nicole Marie Siddell-Duran, R.D.H
• Linda Smith, RDH
• Deborah Gail Swiader, SAC-IT
• Danielle L Turner, RDH
• Patricia A Ustianowski, CADCIII
• Suanne Vannatter, MHNP-BC
• Bradley Clay Walden, DMD
• Chrystal Sacheen Wedde, RDH

• Ambulance in Lac Du Flambeau, WI
• Providers in Lac Du Flambeau, WI by specialty
• Ambulance in Wisconsin

• 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.
• 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.