NPIMap

Organization Active NPI

Goodman Armstrong Rescue Squad Inc

  • Land Ambulance
  • Goodman, WI
National Provider Identifier
1861542078
Registry record updated May 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
6001000 Issued in WI
Legal business name
GOODMAN ARMSTRONG RESCUE SQUAD INC
Practice address
506 Mill St
Goodman, WI 54125-0393
Phone
(715) 336-2027
NPI assigned
Jan 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2012

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

Authorized official

Name
Mrs. Dawn M Stec, EMT-B
Title
Secretary
Phone
(715) 336-2027

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 6001000 WI Primary

Addresses

Primary practice location

506 Mill St
Goodman, WI 54125-0393

Mailing address

PO Box 393
Goodman, WI 54125-0393
Phone (715) 336-2027

Other identifiers 1

IdentifierTypeStateIssuer
41323400MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050617000792 WI Part B Supplier - Ambulance Service Supplier 5890739064 Practice locations: Goodman, 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": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335916800000",
    "number": "1861542078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 393",
            "city": "GOODMAN",
            "state": "WI",
            "postal_code": "541250393",
            "telephone_number": "715-336-2027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 MILL ST",
            "city": "GOODMAN",
            "state": "WI",
            "postal_code": "541250393",
            "telephone_number": "715-336-2027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODMAN ARMSTRONG RESCUE SQUAD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2012-05-02",
        "status": "A",
        "authorized_official_last_name": "STEC",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "715-336-2027",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "EMT-B"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WI",
            "license": "6001000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41323400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodman, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2012; 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.