HATLEY AREA FIRE & AMBULANCE DISTRICT — NPI 1205821584 (Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center in HATLEY, WI)

CMS-1500 Box 24J / 33a • NPI

1205821584

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

261QE0002X

Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center

Box 32 Service Location & ZIP+4

310 CLARK ST, HATLEY, WI, 54440-8704

✓ 9-Digit EDI 837 ZIP+4 (54440-8704)

Practice Phone & Referral Fax

(715) 446-2650

Fax: (715) 446-2241

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1205821584 (HATLEY AREA FIRE & AMBULANCE DISTRICT) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1205821584)

Medicare Beneficiaries

Total Billed Services

753.5

Distinct CPT/HCPCS Codes

Medicare Allowed Total

$20,189.98

Actual Top Billed CPT / HCPCS Procedures (CMS Part B)

CPT / HCPCS	Clinical Procedure Description	Services
`A0425`	Ground mileage, per statute mile	721.5
`A0429`	Ambulance service, basic life support, emergency transport (bls-emergency)	31

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1205821584` (NPI-2 Organization / Facility)
Provider / Legal Name	HATLEY AREA FIRE & AMBULANCE DISTRICT
Plain-English Specialty	Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center NUCC Code: `261QE0002X` (Clinic/Center, Emergency Care)
Certifying / Licensing Body	Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Practice Location Address	310 CLARK ST, HATLEY, WI, 54440-8704
Practice Telephone / Fax	Tel: (715) 446-2650 \| Fax: (715) 446-2241
Administrative Mailing Address	303 E MAIN ST, BOWLER, WI, 54416-9704
Enumeration & Last Sync	Enumerated: 2005-09-13 \| CMS Record Updated: 2020-08-22
Authorized Official	KATHY MAVES (Office Manager)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

310 CLARK ST, HATLEY, WI, 54440-8704

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Plain-English Taxonomy & CMS Crosswalk (261QE0002X)

What Does Taxonomy Code 261QE0002X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 261QE0002X translates to:
"Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Clinical Scope: Same-day outpatient consultations, urgent walk-in medical care, vaccinations, and day-case diagnostic procedures.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (HATLEY AREA FIRE & AMBULANCE DISTRICT)

Typical CPT / Diagnostic Procedures:

Walk-In Urgent Care Evaluation, Point-of-Care Testing & X-Ray
Same-Day Ambulatory Endoscopy, Cataract & Minor Surgical Procedures

Common Therapeutic Classes:

Outpatient Oral Antimicrobials, Analgesics, Nebulizers & Vaccines

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`261QE0002X` — Clinic/Center, Emergency Care Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: WI \| License: `60-01379` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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HATLEY AREA FIRE & AMBULANCE DISTRICT (NPI #1205821584)