Organization Active NPI

American Medical Response Mid-Atlantic, Inc.

  • Ambulance
  • Elkridge, MD
National Provider Identifier
1073977484
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
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 IDStateProvider typePAC IDDetails
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 Directory

Locations

1900 Lansdowne Rd
Ste K
Baltimore, MD 21227
Phone (410) 924-9827

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X Primary
Land Ambulance 3416L0300X

Addresses

NPPES NPI Registry

Primary 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
IdentifierTypeStateIssuer
1073977484OtherTRICARE 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.

Verify at the official NPI Registry.