Active NPI
City of Preston
Doing business as Preston Emergency Service
- Land Ambulance
- Preston, MN
National Provider Identifier
1003976838
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 0199
- Legal business name
- CITY OF PRESTON
- Doing business as
- Preston Emergency Service
- Practice address
- 217 Fillmore St W.
Preston, MN 55965 - Phone
- (507) 765-2153
- NPI assigned
- Dec 11, 2006
- Last updated
- May 21, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ryan Throckmorton
- Title
- Director
- Phone
- (507) 765-2153
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 0199 | MN | Primary |
Addresses
Primary practice location
217 Fillmore St W.
Preston, MN 55965
Mailing address
P.O. Box 657
210 Fillmore St W.
Preston, MN 55965
Phone (507) 765-2153
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 082268000 | Medicaid | MN | |
| 39623PR | Other | MN | BLUE CROSS BLUE SHIELD |
Other names 1
- Preston Emergency Service
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111130000895 | MN | Part B Supplier - Ambulance Service Supplier | 9133393168 | Practice locations: Preston, MN |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 24D2029761 | Preston Emergency Service | Certificate of waiver | Sep 13, 2027 |
National Provider Directory
National Provider DirectoryLocations
210 Fillmore St W
Preston, MN 55965
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1369094400000",
"number": "1003976838",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 657",
"address_2": "210 FILLMORE ST W.",
"city": "PRESTON",
"state": "MN",
"postal_code": "55965",
"telephone_number": "507-765-2153",
"fax_number": "507-765-2794"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "217 FILLMORE ST W.",
"city": "PRESTON",
"state": "MN",
"postal_code": "55965",
"telephone_number": "507-765-2153"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CITY OF PRESTON",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-11",
"last_updated": "2013-05-21",
"status": "A",
"authorized_official_last_name": "THROCKMORTON",
"authorized_official_first_name": "RYAN",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "507-765-2153"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "MN",
"license": "0199",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "082268000",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "39623PR",
"state": "MN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Preston Emergency Service",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Preston, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2013; 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.