Active NPI
Kingston Firemens Community Ambulance
- Land Ambulance
- Kingston, PA
National Provider Identifier
1043206014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 03370
- Legal business name
- KINGSTON FIREMENS COMMUNITY AMBULANCE
- Practice address
- 600 Wyoming Ave
Kingston, PA 18704-3702 - Phone
- (570) 714-0471
- NPI assigned
- Sep 23, 2005
- 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
- Mr. Joe Grimes
- Title
- Manager
- Phone
- (570) 714-0471
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 03370 | PA | Primary |
Addresses
Primary practice location
600 Wyoming Ave
Kingston, PA 18704-3702
Mailing address
PO Box 207
Allentown, PA 18105-0207
Phone (484) 664-2007
Other identifiers 15
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0012514170001 | Other | PA MEDICAID | |
| 0X00PA7945 | Other | PHS HEALTH PLAN HMO MDC | |
| 20010720 | Other | AMERIHEALTH MERCY HMO DPA | |
| 214314 | Other | BCNE CONTRACT CLAIMS | |
| 590011415 | Other | UNITED HC RR MEDICARE | |
| 117946600 | Other | ACS HEALTH NET COMMERCIAL | |
| 117946600 | Other | ACS HEALTH NET HMO MDC | |
| 117946600 | Other | ACS BENEFITS | |
| 892993 | Other | UMWA HEALTH & RETIREMENT | |
| 0110819 | Other | AETNA USHC BLUE BELL HMO | |
| 080783 | Other | FIRST PRIORITY HEALTH | |
| 0X00PA7945 | Other | PHS HEALTH PLAN COMMERCIA | |
| 0X00PA7945 | Other | QUALMED | |
| 214314 | Other | BC BS OF PA BLUE SHIELD | |
| 214314 | Other | BC OF NE PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050505000432 | PA | Part B Supplier - Ambulance Service Supplier | 1254371669 | Practice locations: Kingston, PA |
National Provider Directory
National Provider DirectoryLocations
600 Wyoming Ave
Kingston, PA 18704
Phone (570) 287-3674
22 E Union St
Kingston, PA 18704
Phone (570) 714-0471
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127433600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1362096000000",
"number": "1043206014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 207",
"city": "ALLENTOWN",
"state": "PA",
"postal_code": "181050207",
"telephone_number": "484-664-2007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 WYOMING AVE",
"city": "KINGSTON",
"state": "PA",
"postal_code": "187043702",
"telephone_number": "570-714-0471"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KINGSTON FIREMENS COMMUNITY AMBULANCE",
"organizational_subpart": "NO",
"enumeration_date": "2005-09-23",
"last_updated": "2013-03-01",
"status": "A",
"authorized_official_last_name": "GRIMES",
"authorized_official_first_name": "JOE",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "570-714-0471",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "PA",
"license": "03370",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA MEDICAID",
"identifier": "0012514170001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHS HEALTH PLAN HMO MDC",
"identifier": "0X00PA7945",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH MERCY HMO DPA",
"identifier": "20010720",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCNE CONTRACT CLAIMS",
"identifier": "214314",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HC RR MEDICARE",
"identifier": "590011415",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACS HEALTH NET COMMERCIAL",
"identifier": "117946600",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACS HEALTH NET HMO MDC",
"identifier": "117946600",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACS BENEFITS",
"identifier": "117946600",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UMWA HEALTH & RETIREMENT",
"identifier": "892993",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA USHC BLUE BELL HMO",
"identifier": "0110819",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST PRIORITY HEALTH",
"identifier": "080783",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHS HEALTH PLAN COMMERCIA",
"identifier": "0X00PA7945",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "QUALMED",
"identifier": "0X00PA7945",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS OF PA BLUE SHIELD",
"identifier": "214314",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC OF NE PA",
"identifier": "214314",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Kingston, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.