City of Desoto

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

057044 Issued in TX

Legal business name

CITY OF DESOTO

Practice address

211 E Pleasant Run Rd
Desoto, TX 75115-3901

Phone

(972) 230-9628

Fax

(972) 230-5795

NPI assigned

Feb 1, 2007

Organization subpart

No

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

Authorized official

Name

Bryan Whitacre

Title

EMS Chief

Phone

(972) 230-9682

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• DeSoto Fire Rescue Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621900800000",
    "number": "1063550168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E PLEASANT RUN RD",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751153901",
            "telephone_number": "972-230-9628",
            "fax_number": "972-230-5795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E PLEASANT RUN RD",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751153901",
            "telephone_number": "972-230-9628",
            "fax_number": "972-230-5795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF DESOTO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A",
        "authorized_official_last_name": "WHITACRE",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "EMS CHIEF",
        "authorized_official_telephone_number": "972-230-9682"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "TX",
            "license": "057044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "505775",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000082001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00097954",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DeSoto Fire Rescue",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DeSoto Fire Rescue",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Phuong-Thao Kristy Chounlamany, PA-C
• Chris W. Dyer, DO PA
• Joann Christle, NRCMA, AA HEALTHCARE
• Eke Egbuta Chukwu
• Circle of Healing Chiropractic
• Brianna Clark
• Wesley Ethan Clark, PT
• Eileen Cilia Clavijo
• Clinical Healthcare Consultants
• Cnbfac Creating New Beginning for All Children

• Land Ambulance in Desoto, TX
• Providers in Desoto, TX by specialty
• Land Ambulance in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.