NPIMap

Organization Active NPI

Shelby County Government

  • Land Ambulance
  • Memphis, TN
National Provider Identifier
1083158570
Registry record updated Jan 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
EMS0000010206 Issued in TN
Legal business name
SHELBY COUNTY GOVERNMENT
Practice address
1075 Mullins Station Rd
BLDG. C, 2ND Floor
Memphis, TN 38134-7730
Phone
(901) 222-8010
Fax
(901) 373-4925
NPI assigned
Dec 19, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2017

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

Authorized official

Name
Mr. Donald F Fletcher
Title
Division Chief of EMS
Phone
(901) 222-8010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X EMS0000010206 TN Primary

Addresses

Primary practice location

1075 Mullins Station Rd
BLDG. C, 2ND Floor
Memphis, TN 38134-7730

Mailing address

1075 Mullins Station Rd
BLDG. C, 2ND Floor
Memphis, TN 38134-7730
Phone (901) 222-8010

Other names 1

  • Shelby County Fire Department Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170314001877 TN Part B Supplier - Ambulance Service Supplier 4688633142 Practice locations: Memphis, TN

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Memphis Shelby Co Healt6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

167 Washington St
Collierville, TN 38017
Phone (901) 222-9901

1075 Mullins Station Rd
Bldg C
Memphis, TN 38134
Phone (901) 222-8010

1000 Haynes St
Memphis, TN 38114
Phone (901) 458-9112

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1482105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485216000000",
    "number": "1083158570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 MULLINS STATION RD",
            "address_2": "BLDG. C, 2ND FLOOR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381347730",
            "telephone_number": "901-222-8010",
            "fax_number": "901-373-4925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 MULLINS STATION RD",
            "address_2": "BLDG. C, 2ND FLOOR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381347730",
            "telephone_number": "901-222-8010",
            "fax_number": "901-373-4925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELBY COUNTY GOVERNMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-19",
        "last_updated": "2017-01-24",
        "status": "A",
        "authorized_official_last_name": "FLETCHER",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "DIVISION CHIEF OF EMS",
        "authorized_official_telephone_number": "901-222-8010",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "TN",
            "license": "EMS0000010206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shelby County Fire Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2017; 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.