Highland Ambulance Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

6001069 Issued in WI

Legal business name

HIGHLAND AMBULANCE SERVICE

Practice address

709 Dodgeville St
Highland, WI 53543-9293

Phone

(608) 929-4629

NPI assigned

Oct 1, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Grace H. Mize

Title

Billing Secretary

Phone

(608) 929-4629

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

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

CLIA laboratory certificates

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

{
    "created_epoch": "1128124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841287141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 DODGEVILLE ST",
            "city": "HIGHLAND",
            "state": "WI",
            "postal_code": "535439293",
            "telephone_number": "608-929-4629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 DODGEVILLE ST",
            "city": "HIGHLAND",
            "state": "WI",
            "postal_code": "535439293",
            "telephone_number": "608-929-4629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MIZE",
        "authorized_official_first_name": "GRACE",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "BILLING SECRETARY",
        "authorized_official_telephone_number": "608-929-4629",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WI",
            "license": "6001069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41316000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Denise Lea Bomkamp, R.N.
• Mackenzie Marie Drury
• Geana R Gaasch, MS, ATC
• Highland Chiropractic, LLC
• Highland School District
• Highland Springs Counseling, LLC
• Rachel Ann Miller
• Tricia Ann Morzenti, M.S., LPC

• Land Ambulance in Highland, WI
• Providers in Highland, WI by specialty
• Land Ambulance in Wisconsin

• 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.
• 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.