NPIMap

Organization Active NPI

Village of Grafton

  • Land Ambulance
  • Grafton, WI
National Provider Identifier
1902143639
Registry record updated Jan 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
VILLAGE OF GRAFTON
Practice address
860 Badger Cir
Grafton, WI 53024-9436
Phone
(262) 375-5300
NPI assigned
Jan 15, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2013

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

Authorized official

Name
Darrell Hofland
Title
Village Administrator
Phone
(262) 375-5300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

860 Badger Cir
Grafton, WI 53024-9436

Mailing address

860 Badger Cir
Grafton, WI 53024-9436

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140430000112 WI Part B Supplier - Ambulance Service Supplier 9638302524 Practice locations: Grafton, WI

National Provider Directory

National Provider Directory

Locations

860 Badger Cir
Grafton, WI 53024
Phone (262) 375-5300

NPI Registry JSON

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

{
    "created_epoch": "1358208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358208000000",
    "number": "1902143639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 BADGER CIR",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530249436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 BADGER CIR",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530249436",
            "telephone_number": "262-375-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF GRAFTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-15",
        "last_updated": "2013-01-15",
        "status": "A",
        "authorized_official_last_name": "HOFLAND",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_title_or_position": "VILLAGE ADMINISTRATOR",
        "authorized_official_telephone_number": "262-375-5300"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grafton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2013; 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.