NPIMap

Organization Active NPI

Seminole Tribe of Florida

  • Land Ambulance
  • Clewiston, FL
National Provider Identifier
1033229497
Registry record updated Oct 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
3467 Issued in FL
Legal business name
SEMINOLE TRIBE OF FLORIDA
Practice address
HC 61 Box 49
Clewiston, FL 33440-9502
Phone
(863) 983-2150
Fax
(863) 983-8045
NPI assigned
Aug 30, 2006
Last updated
Oct 23, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2013

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

Authorized official

Name
Ms. Amy Johns
Title
Executive Administrative Officer
Phone
(954) 966-6300

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X
Land Ambulance 3416L0300X 3467 FL Primary

Addresses

Primary practice location

HC 61 Box 49
Clewiston, FL 33440-9502

Mailing address

25640 Network PL
Chicago, IL 60673-1256
Phone (305) 459-0667

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070510000604 FL Part B Supplier - Ambulance Service Supplier 4082710835 Practice locations: Clewiston, FL; Hollywood, FL; Immokalee, FL; Okeechobee, FL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Seminole Tribe of Florida9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

25640 Network Pl
Chicago, IL 60673

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382486400000",
    "number": "1033229497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25640 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731256",
            "telephone_number": "305-459-0667",
            "fax_number": "305-428-5380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HC 61 BOX 49",
            "city": "CLEWISTON",
            "state": "FL",
            "postal_code": "334409502",
            "telephone_number": "863-983-2150",
            "fax_number": "863-983-8045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEMINOLE TRIBE OF FLORIDA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-10-23",
        "status": "A",
        "authorized_official_last_name": "JOHNS",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "EXECUTIVE ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "954-966-6300",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "FL",
            "license": "3467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clewiston, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2013; 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.