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WHITE LAKE AMBULANCE SERVICE
NPI 1225033855
Ambulance - Land Transport in Montague, MI

Active since June 20, 2005CLIA 23D1042026 · Waiver
5085 WILCOX ST, MONTAGUE, MI 49437(231) 894-4306(231) 893-0249 Get Directions Write a Review

NPPES record last updated: June 29, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 29, 2016, Jun 21, 2016 (2 updates tracked since 2016).

About White Lake Ambulance Service NPPES

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

WHITE LAKE AMBULANCE SERVICE (NPI 1225033855) is a healthcare organization registered as a land transport in Montague, Michigan and active in the NPI registry since June 2005. The organization holds a CLIA Waiver certificate valid through June 16, 2027 and lists Jonathon Degen, Director, as its authorized official.

NPPES Registry Identity

NPI1225033855
Entity TypeOrganization
Primary Taxonomy3416L0300X
Legal Business NameWHITE LAKE AMBULANCE SERVICE
Location Address5085 WILCOX STMontague, MI 49437-1558
Mailing Address5085 Wilcox StMontague, MI 49437-1558 · (231) 894-4306 · Fax (231) 893-0249
Phone(231) 894-4306
Fax(231) 893-0249
Organization SubpartNo
Authorized OfficialJonathon DegenDirector · (231) 894-4306
Enumeration DateJune 20, 2005
Last NPPES UpdateJune 29, 20162 updates tracked since enumeration
✔ NPI 1225033855 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAmbulance · Land TransportTransportation Services
Taxonomy Code3416L0300X
License✔ Licensed in MI · 611002
5085 WILCOX ST, Montague, MI 49437
Open in Google Maps ↗

Other Identifiers 3

Medicare ID-Type Unspecified0N15360MI
Medicaid4217295MI
Medicare PIN0N15360MI

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 23D1042026

White Lake Ambulance Authority · Whitehall, MI
Active · expires Jun 16, 2027
CLIA Number23D1042026
Laboratory TypeAmbulance
Certificate Effective DateJune 17, 2025
Certificate Expiration DateJune 16, 2027
Laboratory DirectorJonathan Degen
Laboratory Phone(231) 894-4306
Laboratory LocationWhite Lake Ambulance Authority8220 Whitehall Road, Whitehall, MI 49461
CLIA data matches this NPI record on: 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.
3,210 services125 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.
120 services95 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.
45 services37 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 White Lake Ambulance Service's NPI number?

The NPI number for White Lake Ambulance Service is 1225033855. It was assigned to this organization in the NPPES registry on June 20, 2005.

Where is White Lake Ambulance Service located?

White Lake Ambulance Service is located at 5085 Wilcox St, Montague, MI 49437. The listed phone number is (231) 894-4306.

What is White Lake Ambulance Service's specialty?

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

Does White Lake Ambulance Service hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D1042026) is associated with this NPI, valid through June 16, 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 White Lake Ambulance Service was last updated on June 29, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.