Clintonville Area Ambulance Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

6001047 Issued in WI

Legal business name

CLINTONVILLE AREA AMBULANCE SERVICE

Practice address

16 N. Main
Clintonville, WI 54929

Phone

(715) 823-5967

Fax

(715) 823-1379

NPI assigned

Jul 20, 2006

Last updated

Jan 16, 2023By 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

Ms. Sheryl Lynn Wendorf

Title

Director

Phone

(715) 823-5967

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673827200000",
    "number": "1962422303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98",
            "city": "CLINTONVILLE",
            "state": "WI",
            "postal_code": "549290098",
            "telephone_number": "715-823-5967",
            "fax_number": "715-823-1379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 N. MAIN",
            "city": "CLINTONVILLE",
            "state": "WI",
            "postal_code": "54929",
            "telephone_number": "715-823-5967",
            "fax_number": "715-823-1379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINTONVILLE AREA AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A",
        "authorized_official_last_name": "WENDORF",
        "authorized_official_first_name": "SHERYL",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "715-823-5967",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "WI",
            "license": "6001047",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WI",
            "license": "6001047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41336000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jodi A Boutott, PT
• Bobbi R. Brahan, PHARMD
• Rita Braund, PA
• Shannon Buettner
• Cheryl Mae Chapin, M.S., LPC
• Clintonville Chiropractic Inc
• Clintonville Public School District
• Cloverleaf Healthcare LLC (The Pines Post Acute and Memory Care)
• John W. Connelly, D.D.S
• Daryl Daane, RPH

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.