Elk Horn Rescue

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

2830900 Issued in IA

Legal business name

ELK HORN RESCUE

Doing business as

Elk Horn Fire and Rescue

Practice address

4147 Main
Elk Horn, IA 51531

Phone

(402) 572-4019

Fax

(402) 965-8594

NPI assigned

Aug 21, 2006

Last updated

Sep 10, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Craig A Smith

Title

Secretary

Phone

(402) 572-4019

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• ELK HORN FIRE AND RESCUE Doing business as

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189382400000",
    "number": "1043326291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 641880",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681647880",
            "telephone_number": "402-572-4019",
            "fax_number": "402-965-8594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4147 MAIN",
            "city": "ELK HORN",
            "state": "IA",
            "postal_code": "51531",
            "telephone_number": "402-572-4019",
            "fax_number": "402-965-8594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELK HORN RESCUE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-09-10",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "402-572-4019",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IA",
            "license": "2830900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0497164",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "30643",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ELK HORN FIRE AND RESCUE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• American Lutheran Church (Salem Lutheran Homes)
• Elk Horn-Kimballton Community School District
• Exira-Elk Horn-Kimballton Community School District
• Julie Lynn Nielsen, ARNP
• Robyn Renee Peterson, COTA L
• Kinsey Olivia-Marie Phifer

• Land Ambulance in Elk Horn, IA
• Providers in Elk Horn, IA by specialty
• Land Ambulance in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2007; 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.