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THERESA AMBULANCE SERVICE
NPI 1104804657
Ambulance - Land Transport in Theresa, WI

Active since January 05, 2006CLIA 52D0984714 · Waiver
302 DEPOT ROAD, THERESA, WI 53091(920) 488-6301(920) 488-6301 Get Directions Write a Review

NPPES record last updated: April 30, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Theresa Ambulance Service NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THERESA AMBULANCE SERVICE (NPI 1104804657) is a healthcare organization registered as a land transport in Theresa, Wisconsin and active in the NPI registry since January 2006. The organization holds a CLIA Waiver certificate valid through March 27, 2027 and lists Kevin Lester Baerwald, Operation Manager, as its authorized official.

NPPES Registry Identity

NPI1104804657
Entity TypeOrganization
Primary Taxonomy3416L0300X
Legal Business NameTHERESA AMBULANCE SERVICE
Location Address302 DEPOT ROADTheresa, WI 53091
Mailing AddressPo Box 275Theresa, WI 53091-0275 · (920) 488-6301 · Fax (920) 488-6301
Phone(920) 488-6301
Fax(920) 488-6301
Organization SubpartNo
Authorized OfficialKevin Lester BaerwaldOperation Manager · (920) 488-6301
Enumeration DateJanuary 5, 2006
Last NPPES UpdateApril 30, 2012
✔ NPI 1104804657 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAmbulance · Land TransportTransportation Services
Taxonomy Code3416L0300X
License✔ Licensed in WI · 6000326
302 DEPOT ROAD, Theresa, WI 53091
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Other Identifiers 2

Medicare ID-Type Unspecified000081207WI · Medicare Provider Number
Medicaid41328600WI

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 52D0984714

Theresa Ambulance Service · Theresa, WI
Active · expires Mar 27, 2027
CLIA Number52D0984714
Laboratory TypeAmbulance
Certificate Effective DateMarch 28, 2025
Certificate Expiration DateMarch 27, 2027
Laboratory DirectorCharles Trauba
Laboratory Phone(920) 488-6301
Laboratory LocationTheresa Ambulance Service303 Depot Rd, Theresa, WI 53091
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Ground mileage, per statute mile A0425
Ground mileage per statute mile is a method of calculating the cost of transportation for medical services. It is used when a patient needs to be transported by ground ambulance. The cost is calculated per mile, from the pick-up location to the medical facility.
1,107 services37 patients
Ambulance service, basic life support, emergency transport (bls-emergency) A0429
Ambulance service with basic life support (BLS-Emergency) provides immediate transport for patients in critical situations. Medical professionals on board deliver essential care like CPR, wound dressing, and oxygen therapy to stabilize patients during the journey.
41 services29 patients
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) A0427
Ambulance Service, Advanced Life Support, Level 1 (ALS 1 - Emergency) is a critical care transport service for emergency situations. It includes a team of healthcare professionals equipped with advanced skills and tools to manage life-threatening conditions during transport.
13 services13 patients

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theresa Ambulance Service's NPI number?

The NPI number for Theresa Ambulance Service is 1104804657. It was assigned to this organization in the NPPES registry on January 5, 2006.

Where is Theresa Ambulance Service located?

Theresa Ambulance Service is located at 302 Depot Road, Theresa, WI 53091. The listed phone number is (920) 488-6301.

What is Theresa Ambulance Service's specialty?

The primary specialty registered for this NPI is Ambulance, specializing in Land Transport, with taxonomy code 3416L0300X.

Does Theresa Ambulance Service hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D0984714) is associated with this NPI, valid through March 27, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Theresa Ambulance Service was last updated on April 30, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.