Rockford Ambulance Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

411004 Issued in MI

Legal business name

ROCKFORD AMBULANCE INC

Practice address

8450 Shaner Ave NE
Rockford, MI 49341-9379

Phone

(616) 866-0724

Fax

(616) 866-3903

NPI assigned

Jun 18, 2006

Last updated

Dec 2, 2014By the provider in NPPES

Organization subpart

Yes

Parent organization

ROCKFORD AMBULANCE INCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Rissie Haack

Title

Office Manger

Phone

(616) 866-0724

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Lowell Ambulance, Sparta Ambulance, Grand Rapids Twp. Ambulance Other name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

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

CLIA laboratory certificates

Part of

Rockford Ambulance Inc

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417478400000",
    "number": "1013952589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8450 SHANER AVE. NE",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "49341",
            "telephone_number": "616-866-0724",
            "fax_number": "616-866-3903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8450 SHANER AVE NE",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493419379",
            "telephone_number": "616-866-0724",
            "fax_number": "616-866-3903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKFORD AMBULANCE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROCKFORD AMBULANCE INC",
        "enumeration_date": "2006-06-18",
        "last_updated": "2014-12-02",
        "status": "A",
        "authorized_official_last_name": "HAACK",
        "authorized_official_first_name": "RISSIE",
        "authorized_official_title_or_position": "OFFICE MANGER",
        "authorized_official_telephone_number": "616-866-0724",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MI",
            "license": "411004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3001478",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "590D10018",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590058353",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lowell Ambulance, Sparta Ambulance, Grand Rapids Twp. Ambulance",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Land Ambulance in Rockford, MI
• Providers in Rockford, MI by specialty
• Land Ambulance in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; 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.