City of Lake Geneva

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

6001201 Issued in WI

Legal business name

CITY OF LAKE GENEVA

Practice address

730 Marshall St
Lake Geneva, WI 53147-1436

Phone

(262) 248-3673

Fax

(262) 248-4715

NPI assigned

May 26, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Diana Dykstra

Title

City Clerk

Phone

(262) 248-3673

Specialties & licenses 1

Addresses

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": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1760438246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 GENEVA ST",
            "address_2": "CITY HALL",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531471914",
            "telephone_number": "262-248-3673",
            "fax_number": "262-248-4715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 MARSHALL ST",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531471436",
            "telephone_number": "262-248-3673",
            "fax_number": "262-248-4715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF LAKE GENEVA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "DYKSTRA",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "CITY CLERK",
        "authorized_official_telephone_number": "262-248-3673",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WI",
            "license": "6001201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Michael Cesarz, R.PH.
• Amy Jo Ceshker
• James Chapman, P.T.
• Yvonne Chentnik
• Daniel M Christy
• CJR Partners LLC
• Christina L. Clancy, C.N.P.
• Marguerite R Compton, MD
• Amie Lee Conley, LPN
• Robert Conlon, D.D.S.

• Land Ambulance in Lake Geneva, WI
• Providers in Lake Geneva, WI by specialty
• Land Ambulance in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; 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.