NPIMap

Organization Active NPI

Integrated First Response-Great Lakes

  • Land Ambulance
  • Iron Mountain, MI
National Provider Identifier
1083044762
Registry record updated Nov 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
221010 Issued in MI
Legal business name
INTEGRATED FIRST RESPONSE-GREAT LAKES
Practice address
719 River Avenue
Iron Mountain, MI 49801
Phone
(855) 437-9111
Fax
(605) 582-8983
NPI assigned
Nov 18, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2013

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

Authorized official

Name
Douglas D Anderson
Title
Treasurer
Phone
(605) 366-3299

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 221010 MI Primary

Addresses

Primary practice location

719 River Avenue
Iron Mountain, MI 49801

Mailing address

PO Box 1137
Herndon, VA 20172-1137
Phone (855) 437-9114

Other identifiers 1

IdentifierTypeStateIssuer
MI6850OtherMIMEDICARE PTAN

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1384732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384732800000",
    "number": "1083044762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1137",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201721137",
            "telephone_number": "855-437-9114",
            "fax_number": "866-388-5227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 RIVER AVENUE",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "49801",
            "telephone_number": "855-437-9111",
            "fax_number": "605-582-8983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED FIRST RESPONSE-GREAT LAKES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-18",
        "last_updated": "2013-11-18",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "605-366-3299"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MI",
            "license": "221010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "MI6850",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iron Mountain, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.