Active NPI
Hurley Volunteer Fire Department, Inc
Doing business as Hurley Ambulance
- Land Ambulance
- Hurley, SD
National Provider Identifier
1053819367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- Legal business name
- HURLEY VOLUNTEER FIRE DEPARTMENT, INC
- Doing business as
- Hurley Ambulance
- Practice address
- 311 Main Street
Hurley, SD 57036 - Phone
- (605) 238-5888
- Fax
- (605) 238-5888
- NPI assigned
- Feb 1, 2018
- Last updated
- Jun 16, 2018
- Organization subpart
- Yes
- Parent organization
- AMBULANCE SERVICE
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Christopher Alan Mikkelson, PARAMEDIC
- Title
- Compliance Officer
- Phone
- (605) 413-9774
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | NU | Primary |
Addresses
Primary practice location
311 Main Street
Hurley, SD 57036
Mailing address
PO Box 421
Hurley, SD 57036-0421
Phone (605) 238-5888
Other names 1
- Hurley Ambulance
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SD
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180214002889 | SD | Part B Supplier - Ambulance Service Supplier | 6507126497 | Practice locations: Hurley, SD |
National Provider Directory
National Provider Directory- Part of
- Hurley Volunteer Fire Dept
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517443200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1529107200000",
"number": "1053819367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 421",
"city": "HURLEY",
"state": "SD",
"postal_code": "570360421",
"telephone_number": "605-238-5888",
"fax_number": "605-238-5888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 MAIN STREET",
"city": "HURLEY",
"state": "SD",
"postal_code": "57036",
"telephone_number": "605-238-5888",
"fax_number": "605-238-5888"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HURLEY VOLUNTEER FIRE DEPARTMENT, INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "AMBULANCE SERVICE",
"enumeration_date": "2018-02-01",
"last_updated": "2018-06-16",
"status": "A",
"authorized_official_last_name": "MIKKELSON",
"authorized_official_first_name": "CHRISTOPHER",
"authorized_official_middle_name": "ALAN",
"authorized_official_title_or_position": "COMPLIANCE OFFICER",
"authorized_official_telephone_number": "605-413-9774",
"authorized_official_credential": "PARAMEDIC"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Hurley Ambulance",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Hurley, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.