Village of Eagle

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

5126 Issued in NE

Legal business name

VILLAGE OF EAGLE

Practice address

701 S.1St St
Eagle, NE 68347-0130

Phone

(402) 781-2748

Fax

(402) 781-2775

NPI assigned

Aug 5, 2010

Organization subpart

No

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

Authorized official

Name

Nick Nystrom

Title

Treasurer

Phone

(402) 781-2748

Specialties & licenses 1

Addresses

Other names 1

• EAGLE VOL. FIRE & RESCUE Doing business as

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

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

{
    "created_epoch": "1280966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675814400000",
    "number": "1831403559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10802 FARNAM DR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681543237",
            "telephone_number": "877-218-4392",
            "fax_number": "877-343-0131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S.1ST ST",
            "city": "EAGLE",
            "state": "NE",
            "postal_code": "683470130",
            "telephone_number": "402-781-2748",
            "fax_number": "402-781-2775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF EAGLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-05",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A",
        "authorized_official_last_name": "NYSTROM",
        "authorized_official_first_name": "NICK",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "402-781-2748"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NE",
            "license": "5126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EAGLE VOL. FIRE & RESCUE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "EAGLE VOL. FIRE & RESCUE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Summit Equine Therapy LLC
• Susan Louise Torpin
• Gail Patricia Trusow
• Cheryl A Vanmeveren, LMHP CMSW LCSW
• Melissa Ann Vavra
• Benjamin Lee Wiechman, RN

• Land Ambulance in Eagle, NE
• Providers in Eagle, NE by specialty
• Land Ambulance in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; 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.