Smith County Ambulance Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

EMS0000008001 Issued in TN

Legal business name

SMITH COUNTY AMBULANCE SERVICE

Doing business as

Smith County EMS

Practice address

303 High St N
Carthage, TN 37030-1429

Phone

(615) 735-6232

Fax

(615) 735-9712

NPI assigned

Feb 10, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jeffrey Crockett

Title

Director

Phone

(615) 735-2121

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Smith County EMS Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641340800000",
    "number": "1033182704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 HIGH ST N",
            "city": "CARTHAGE",
            "state": "TN",
            "postal_code": "370301429",
            "telephone_number": "615-735-6232",
            "fax_number": "615-735-9712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 HIGH ST N",
            "city": "CARTHAGE",
            "state": "TN",
            "postal_code": "370301429",
            "telephone_number": "615-735-6232",
            "fax_number": "615-735-9712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITH COUNTY AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-10",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A",
        "authorized_official_last_name": "CROCKETT",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "615-735-2121",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "TN",
            "license": "EMS0000008001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3500934",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "4110219",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENNCARE SELECT",
            "identifier": "2003290",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smith County EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephanie Ruckman, NP
• Richard T Rutherford, M.D.
• Sarah Catherine Rutherford, DO
• Mistee Johnson Silvey, LPN
• Smith Co Board of Education
• Smith County Drug Center Inc
• Smith County Family Practice, PC
• Smith County Memorial Hospital LLC
• Smith County Memorial Hospital LLC
• Smith County Memorial Hospital LLC

• Land Ambulance in Carthage, TN
• Providers in Carthage, TN by specialty
• Land Ambulance in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.