Active NPI
American Medical Response Mid-Atlantic, Inc.
- Ambulance
- Elkridge, MD
National Provider Identifier
1073977484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulance
- Legal business name
- AMERICAN MEDICAL RESPONSE MID-ATLANTIC, INC.
- Practice address
- 6525 Washington Blvd
Elkridge, MD 21075-5533 - Phone
- (410) 328-1101
- Fax
- (800) 498-2527
- NPI assigned
- Apr 12, 2016
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Edward Van Horne
- Title
- Coo
- Phone
- (303) 495-1220
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records 1
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160914002534 | MD | Part B Supplier - Ambulance Service Supplier | 9133179716 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Elkridge, MD |
National Provider Directory
National Provider DirectoryLocations
1900 Lansdowne Rd
Ste K
Baltimore, MD 21227
Phone (410) 924-9827
Specialties & licenses 2
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | Primary | ||
| Land Ambulance | 3416L0300X |
Addresses
NPPES NPI RegistryPrimary practice location
6525 Washington Blvd
Elkridge, MD 21075-5533
Mailing address
PO Box 409880
Atlanta, GA 30384-9880
Phone (303) 495-1748
Other identifiers 1
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073977484 | Other | TRICARE NORTH |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 10, 2021.
{
"created_epoch": "1460419200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1615334400000",
"number": "1073977484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 409880",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303849880",
"telephone_number": "303-495-1748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6525 WASHINGTON BLVD",
"city": "ELKRIDGE",
"state": "MD",
"postal_code": "210755533",
"telephone_number": "410-328-1101",
"fax_number": "800-498-2527"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AMERICAN MEDICAL RESPONSE MID-ATLANTIC, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2016-04-12",
"last_updated": "2021-03-10",
"certification_date": "2021-03-10",
"status": "A",
"authorized_official_last_name": "VAN HORNE",
"authorized_official_first_name": "EDWARD",
"authorized_official_title_or_position": "COO",
"authorized_official_telephone_number": "303-495-1220"
},
"taxonomies": [
{
"code": "341600000X",
"taxonomy_group": "",
"desc": "Ambulance",
"state": null,
"license": null,
"primary": true
},
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE NORTH",
"identifier": "1073977484",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Elkridge, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.