City of Polk City

Primary specialty

AmbulanceTaxonomy code 341600000X

License

2771000 Issued in IA

Legal business name

CITY OF POLK CITY

Practice address

309 W. Van Dorn
Polk City, IA 50226-0034

Phone

(515) 984-6304

Fax

(515) 984-6792

NPI assigned

Dec 8, 2006

Organization subpart

Yes

Parent organization

CITY OF POLK CITYAs reported in NPPES

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

Authorized official

Name

Dan A. Gubbins

Title

Fire Chief

Phone

(515) 984-6304

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Polk City Fire Rescue Department Other name

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

City of Polk City

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377734400000",
    "number": "1073673463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 426",
            "address_2": "112 3RD ST",
            "city": "POLK CITY",
            "state": "IA",
            "postal_code": "502260034",
            "telephone_number": "515-984-6233",
            "fax_number": "515-984-6792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 W. VAN DORN",
            "city": "POLK CITY",
            "state": "IA",
            "postal_code": "502260034",
            "telephone_number": "515-984-6304",
            "fax_number": "515-984-6792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF POLK CITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CITY OF POLK CITY",
        "enumeration_date": "2006-12-08",
        "last_updated": "2013-08-29",
        "status": "A",
        "authorized_official_last_name": "GUBBINS",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "515-984-6304"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "IA",
            "license": "2771000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0142760",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Polk City Fire Rescue Department",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jennifer Blaylock, FNP
• James Leroy Blessman, MD
• Seth Bonifas
• Brenda Lee Carlson, APRN, ACNS-BC
• Centers for Long Term Care of Iowa
• Cornerstone Dental Group LLC
• Cornerstone Dental of Iowa,LLC
• Cornerstone Dental of Polk City LLC
• Cornerstone Dental Staffing LLC
• Kristin Marie Davis, ARNP

• Ambulance in Polk City, IA
• Providers in Polk City, IA by specialty
• Ambulance in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.