Physicians Ambulance Service of Indiana, LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

PHYSICIANS AMBULANCE SERVICE OF INDIANA, LLC

Practice address

3305 Nichol Ave
Anderson, IN 46011-3001

Phone

(502) 619-8839

Fax

(502) 531-0103

NPI assigned

Oct 30, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Kenneth Jackson

Title

President Managing Partner

Phone

(765) 863-7033

Specialties & licenses 1

Addresses

Other names 1

• Physicians Ambulance Service Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kathrynne Johns

  • Student in an Organized Health Care Education/Training Program
  • Lakewood, CO
  • NPI 1275001661
  NPD

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

{
    "created_epoch": "1604016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1073113759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 787",
            "city": "PORT NECHES",
            "state": "TX",
            "postal_code": "776510787",
            "telephone_number": "502-619-8399",
            "fax_number": "502-530-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 NICHOL AVE",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460113001",
            "telephone_number": "502-619-8839",
            "fax_number": "502-531-0103"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "408 W Air Park Dr",
            "address_purpose": "LOCATION",
            "city": "Muncie",
            "state": "IN",
            "postal_code": "473031886",
            "country_code": "US",
            "telephone_number": "765-863-5150",
            "fax_number": "765-863-5150",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4038 Park 65 Dr",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462542500",
            "country_code": "US",
            "telephone_number": "502-619-8839",
            "fax_number": "502-531-0103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHYSICIANS AMBULANCE SERVICE OF INDIANA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-30",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT MANAGING PARTNER",
        "authorized_official_telephone_number": "765-863-7033",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physicians Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Physicians Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David John Phillips, FNP-BC
• Kristain Nicole Phillips, NP
• Phoenix Community Services
• James Photiadis, M.D.
• Phyllis M Olson PSYD HSPP LLC
• Physicians Weight Loss Center
• Briana Ellen Pickering, RBT
• Andrell Pickett
• Chelsea Elizabeth Pierce, RBT
• Philip Pinegar, MD

• Land Ambulance in Anderson, IN
• Providers in Anderson, IN by specialty
• Land Ambulance in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.