NPIMap

Organization Active NPI

Black Creek Rescue Service

  • Ambulance
  • Black Creek, WI
National Provider Identifier
1942233648
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
60-01367 Issued in WI
Legal business name
BLACK CREEK RESCUE SERVICE
Practice address
W5200 County Rd B
Black Creek, WI 54106
Phone
(920) 984-3444
Fax
(920) 984-9395
NPI assigned
Jul 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kathy Pasch, EMT-I
Title
Cooridinatorfinancial Secretary
Phone
(920) 213-1513

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 60-01367 WI Primary

Addresses

Primary practice location

W5200 County Rd B
Black Creek, WI 54106

Mailing address

W5200 County Rd B
PO Box 143
Black Creek, WI 54106
Phone (920) 984-3444

Other identifiers 1

IdentifierTypeStateIssuer
41305100MedicaidWI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942233648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W5200 COUNTY RD B",
            "address_2": "PO BOX 143",
            "city": "BLACK CREEK",
            "state": "WI",
            "postal_code": "54106",
            "telephone_number": "920-984-3444",
            "fax_number": "920-984-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W5200 COUNTY RD B",
            "city": "BLACK CREEK",
            "state": "WI",
            "postal_code": "54106",
            "telephone_number": "920-984-3444",
            "fax_number": "920-984-9395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK CREEK RESCUE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PASCH",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "COORIDINATORFINANCIAL SECRETARY",
        "authorized_official_telephone_number": "920-213-1513",
        "authorized_official_credential": "EMT-I"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "WI",
            "license": "60-01367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41305100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Black Creek, WI

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.