Mondovi Area Ambulance Commission

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

6001087 Issued in WI

Legal business name

MONDOVI AREA AMBULANCE COMMISSION

Practice address

156 S Franklin St
Mondovi, WI 54755-1514

Phone

(715) 926-3772

NPI assigned

Oct 14, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Randolph C Isaacson

Title

Service Director

Phone

(715) 577-2320

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mondovi Ambulance Service Doing business as

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": "1192320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192320000000",
    "number": "1972791044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 S FRANKLIN ST",
            "city": "MONDOVI",
            "state": "WI",
            "postal_code": "547551514",
            "telephone_number": "715-926-3772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 S FRANKLIN ST",
            "city": "MONDOVI",
            "state": "WI",
            "postal_code": "547551514",
            "telephone_number": "715-926-3772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONDOVI AREA AMBULANCE COMMISSION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-14",
        "last_updated": "2007-10-14",
        "status": "A",
        "authorized_official_last_name": "ISAACSON",
        "authorized_official_first_name": "RANDOLPH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SERVICE DIRECTOR",
        "authorized_official_telephone_number": "715-577-2320",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WI",
            "license": "6001087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41323100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mondovi Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2007; 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.