NPIMap

Organization Active NPI

Bayfield Community Ambulance Service

  • Land Ambulance
  • Bayfield, WI
National Provider Identifier
1811034390
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
60-1021 Issued in WI
Legal business name
BAYFIELD COMMUNITY AMBULANCE SERVICE
Practice address
813 Washington Ave.
Bayfield, WI 54814-0230
Phone
(715) 779-3356
NPI assigned
Jan 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Shirley Hanson
Title
Secretarytreasurer
Phone
(715) 779-3356

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 60-1021 WI Primary

Addresses

Primary practice location

813 Washington Ave.
Bayfield, WI 54814-0230

Mailing address

PO Box 230
Bayfield, WI 54814-0230
Phone (715) 779-3356

Other identifiers 1

IdentifierTypeStateIssuer
41321400MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120430000768 WI Part B Supplier - Ambulance Service Supplier 3476715921 Practice locations: Bayfield, WI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811034390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 230",
            "city": "BAYFIELD",
            "state": "WI",
            "postal_code": "548140230",
            "telephone_number": "715-779-3356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 WASHINGTON AVE.",
            "city": "BAYFIELD",
            "state": "WI",
            "postal_code": "548140230",
            "telephone_number": "715-779-3356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYFIELD COMMUNITY AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HANSON",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_title_or_position": "SECRETARYTREASURER",
        "authorized_official_telephone_number": "715-779-3356",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WI",
            "license": "60-1021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41321400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayfield, WI

Sources for this page

  • 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.