Village of Waterford

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

VILLAGE OF WATERFORD

Doing business as

Waterford Rescue

Practice address

122 N 2ND St
Waterford, WI 53185-4314

Phone

(262) 375-9610

Fax

(262) 375-9608

NPI assigned

Feb 16, 2007

Organization subpart

No

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

Authorized official

Name

Rebecca Ewald

Title

Village Administrator

Phone

(262) 534-7912

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Waterford Rescue Doing business as

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": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475020800000",
    "number": "1952445918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 N RIVER ST",
            "city": "WATERFORD",
            "state": "WI",
            "postal_code": "531854149",
            "telephone_number": "262-375-9610",
            "fax_number": "262-375-9608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 N 2ND ST",
            "city": "WATERFORD",
            "state": "WI",
            "postal_code": "531854314",
            "telephone_number": "262-375-9610",
            "fax_number": "262-375-9608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF WATERFORD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2016-09-28",
        "status": "A",
        "authorized_official_last_name": "EWALD",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "VILLAGE ADMINISTRATOR",
        "authorized_official_telephone_number": "262-534-7912"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70010500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waterford Rescue",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Denis J Tonsfeldt, M.D.
• Dan Trittin, D.D.S.
• Jeanette M Troha, SLP
• Kimberley G Van Buren, NP
• Sara Vandermolen, OTD, OTR/L
• Thomas C Viney, D.D.S.
• Vita Hearing Care, LLC
• Crystal Laura Voigt, FNP-BC
• Patti Wagner, LPC
• Walgreen Co

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2016; 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.