Organization Active NPI

City of Jefferson

  • Land Ambulance
  • Jefferson, WI
National Provider Identifier
1770697153
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
CITY OF JEFFERSON
Practice address
351 E Racine St
Jefferson, WI 53549-1648
Phone
(920) 674-2751
NPI assigned
Aug 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Authorized official

Name
Susan Reinen
Title
EMS Director
Phone
(920) 674-2751

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

351 E Racine St
Jefferson, WI 53549-1648

Mailing address

PO Box 547
Wheeling, IL 60090-0547
Phone (847) 305-5236

Other names 1

  • JEFFERSON EMS Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090611000724 WI Part B Supplier - Ambulance Service Supplier 3375693302 Practice locations: Jefferson, WI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D0989084Jefferson EMS351 E Racine St, Jefferson, WI 53549Certificate of waiverJul 16, 2027

National Provider Directory

National Provider Directory

Locations

121 W Racine St
Jefferson, WI 53549
Phone (920) 674-2751

351 E Racine St
Jefferson, WI 53549
Phone (920) 674-2751

317 S Main St
Jefferson, WI 53549

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738108800000",
    "number": "1770697153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600900547",
            "telephone_number": "847-305-5236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 E RACINE ST",
            "city": "JEFFERSON",
            "state": "WI",
            "postal_code": "535491648",
            "telephone_number": "920-674-2751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF JEFFERSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A",
        "authorized_official_last_name": "REINEN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "EMS DIRECTOR",
        "authorized_official_telephone_number": "920-674-2751"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JEFFERSON EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jefferson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; 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.