Village of Fontana on Geneva Lake

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

6000137 Issued in WI

Legal business name

VILLAGE OF FONTANA ON GENEVA LAKE

Practice address

190 Fontana Boulevard
Fontana, WI 53125-1000

Phone

(262) 275-2131

Fax

(262) 275-2257

NPI assigned

Jun 13, 2006

Organization subpart

Yes

Parent organization

VILLAGE OF FONTANA-ON-GENEVA LAKEAs reported in NPPES

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

Authorized official

Name

Dennis Lee Martin

Title

Administrator

Phone

(262) 275-6136

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Fontana Fire/Rescue 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

Part of

Village of Fontana on Geneva Lake

Locations

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720569600000",
    "number": "1760425375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POST OFFICE BOX 200",
            "address_2": "175 VALLEY VIEW DRIVE",
            "city": "FONTANA",
            "state": "WI",
            "postal_code": "531251192",
            "telephone_number": "262-275-6136",
            "fax_number": "262-275-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 FONTANA BOULEVARD",
            "city": "FONTANA",
            "state": "WI",
            "postal_code": "531251000",
            "telephone_number": "262-275-2131",
            "fax_number": "262-275-2257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF FONTANA ON GENEVA LAKE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VILLAGE OF FONTANA-ON-GENEVA LAKE",
        "enumeration_date": "2006-06-13",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "262-275-6136"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WI",
            "license": "6000137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WISCONSIN RENAL PROGRAM",
            "identifier": "41355400",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41355400",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "H.I.R.S.P.",
            "identifier": "41355400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fontana Fire/Rescue",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joint School District 8 Fontana
• Karen P Littig, LPC
• Jeremy Steven Lois, D.D.S.
• David E McCann, D.D.S.
• Joyan Sanios, DTH
• Wilson Chiropractic LLC

• All providers in Fontana, WI
• Land Ambulance in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.