Active NPI
Mercer Area Ambulance and Rescue Inc
- Land Ambulance
- Mercer, WI
National Provider Identifier
1831143429
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- Legal business name
- MERCER AREA AMBULANCE AND RESCUE INC
- Practice address
- 5267 N Vaughn St
Mercer, WI 54547-9320 - Phone
- (715) 476-2056
- NPI assigned
- May 19, 2006
- Last updated
- Oct 23, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kelly Joustra
- Title
- Director
- Phone
- (715) 562-0303
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | NU | Primary |
Addresses
Primary practice location
5267 N Vaughn St
Mercer, WI 54547-9320
Mailing address
PO Box 409
Mercer, WI 54547-0409
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000083661 | Other | ADVOCARE MCHMO | |
| 1012415 | Other | PHYSICIAN'S PLUS | |
| 41333300 | Medicaid | WI | |
| WI0101 | Other | JOHN DEERE | |
| 184842370 | Medicaid | MI | |
| 46301 | Other | NETWORK HEALTH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041230000592 | WI | Part B Supplier - Ambulance Service Supplier | 7416915848 | Practice locations: Mercer, WI |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1729641600000",
"number": "1831143429",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 409",
"city": "MERCER",
"state": "WI",
"postal_code": "545470409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5267 N VAUGHN ST",
"city": "MERCER",
"state": "WI",
"postal_code": "545479320",
"telephone_number": "715-476-2056"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MERCER AREA AMBULANCE AND RESCUE INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-19",
"last_updated": "2024-10-23",
"certification_date": "2024-10-23",
"status": "A",
"authorized_official_last_name": "JOUSTRA",
"authorized_official_first_name": "KELLY",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "715-562-0303"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ADVOCARE MCHMO",
"identifier": "000083661",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICIAN'S PLUS",
"identifier": "1012415",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "41333300",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE",
"identifier": "WI0101",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184842370",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NETWORK HEALTH",
"identifier": "46301",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Mercer, WI
- Anne Louis, LPCT
- Timothy Lutgen, MS, RPH, PD
- Marshfield Clinic Inc (Marshfield Clinic Pharmacy Mercer Remote Dispensing Site)
- Marshfield Clinic Inc (Marshfield Clinic Dispensing)
- MCHS Hospitals Inc ((Inactive) Marshfield Clinic Mercer Center)
- Mercer Dental LLC (Rasmussen Dental LLC)
- Mercer Family Dental LLC (Rasmussen Dental)
- Mercer School District
- Jeffrey M Nehring, DDS
- Nils A Olson, DO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.