Organization Active NPI

City of Preston

Doing business as Preston Emergency Service

  • Land Ambulance
  • Preston, MN
National Provider Identifier
1003976838
Registry record updated May 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
0199 Issued in MN
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, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2013

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
082268000MedicaidMN
39623PROtherMNBLUE CROSS BLUE SHIELD

Other names 1

  • Preston Emergency Service Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111130000895 MN Part B Supplier - Ambulance Service Supplier 9133393168 Practice locations: Preston, MN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D2029761Preston Emergency Service217 Fillmore Street West, Preston, MN 55965Certificate of waiverSep 13, 2027

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.