City of Fort Atkinson

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

6604847 Issued in WI

Legal business name

CITY OF FORT ATKINSON

Doing business as

Fort Atkinson Fire Department

Practice address

124 Milwaukee Ave W
Fort Atkinson, WI 53538

Phone

(920) 563-7795

NPI assigned

May 17, 2018

Organization subpart

Yes

Parent organization

CITY OF FORT ATKINSONAs reported in NPPES

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

Authorized official

Name

Daryl A Rausch

Title

Fire Chief

Phone

(920) 563-7795

Specialties & licenses 1

Addresses

Other names 1

• Fort Atkinson Fire Department Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Part of

City of Fort Atkinson

Locations

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

{
    "created_epoch": "1526515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532304000000",
    "number": "1972093706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 MILWAUKEE AVE W",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535382020",
            "telephone_number": "920-563-7795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 MILWAUKEE AVE W",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "53538",
            "telephone_number": "920-563-7795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF FORT ATKINSON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CITY OF FORT ATKINSON",
        "enumeration_date": "2018-05-17",
        "last_updated": "2018-07-23",
        "status": "A",
        "authorized_official_last_name": "RAUSCH",
        "authorized_official_first_name": "DARYL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "920-563-7795"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WI",
            "license": "6604847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fort Atkinson Fire Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carol Jean Christensen, OTR
• Joyce Rene Christensen, RN
• Christine A Chuppa, M.D.
• Jeffrey A Cichocki, CRNA
• Laura K. Cichocki, CRNA
• James A Clark, CADCIII
• Luann S Clark, RN
• Michael Anthony Coletta, RPH
• Colleen a. Mitchell Psychological Services
• Clark A Collins, PA-C

• Land Ambulance in Fort Atkinson, WI
• Providers in Fort Atkinson, WI by specialty
• Land Ambulance in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2018; 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.