Waunakee Area Emergency Medical Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

6001221 Issued in WI

Legal business name

WAUNAKEE AREA EMERGENCY MEDICAL SERVICE

Practice address

201 N Klein Dr
Waunakee, WI 53597-1145

Phone

(608) 849-7522

Fax

(608) 849-7583

NPI assigned

Aug 23, 2006

Last updated

Oct 28, 2008By 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

Mr. Jay M Gawlikoski

Title

Service Administrator

Phone

(608) 849-7522

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225152000000",
    "number": "1881701258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33",
            "address_2": "201 N KLEIN DR",
            "city": "WAUNAKEE",
            "state": "WI",
            "postal_code": "535970033",
            "telephone_number": "608-849-7522",
            "fax_number": "608-849-7583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N KLEIN DR",
            "city": "WAUNAKEE",
            "state": "WI",
            "postal_code": "535971145",
            "telephone_number": "608-849-7522",
            "fax_number": "608-849-7583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAUNAKEE AREA EMERGENCY MEDICAL SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2008-10-28",
        "status": "A",
        "authorized_official_last_name": "GAWLIKOSKI",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SERVICE ADMINISTRATOR",
        "authorized_official_telephone_number": "608-849-7522",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WI",
            "license": "6001221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41308800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; 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.