NPIMap

Organization Active NPI

Liberty County Ambulance Service

  • Paramedic
  • Bristol, FL
National Provider Identifier
1093743775
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ParamedicTaxonomy code 146L00000X
License
002611 Issued in FL
Legal business name
LIBERTY COUNTY AMBULANCE SERVICE
Practice address
12503 NW Virginia G Weaver St
Bristol, FL 32321-0399
Phone
(850) 643-5866
Fax
(850) 643-2866
NPI assigned
Jun 29, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Katherine H Pippin, PARAMEDIC
Title
Director
Phone
(850) 643-5866

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Paramedic 146L00000X 002611 FL Primary

Addresses

Primary practice location

12503 NW Virginia G Weaver St
Bristol, FL 32321-0399

Mailing address

12503 NW Virginia G Weaver St
Bristol, FL 32321-0399
Phone (850) 643-5866

National Provider Directory

National Provider Directory
Tax ID family
County of Liberty Board of County Commissioners2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

12503 NW Virginia G Weaver St
Bristol, FL 32321
Phone (850) 643-5866

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093743775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12503 NW VIRGINIA G WEAVER ST",
            "city": "BRISTOL",
            "state": "FL",
            "postal_code": "323210399",
            "telephone_number": "850-643-5866",
            "fax_number": "850-643-2866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12503 NW VIRGINIA G WEAVER ST",
            "city": "BRISTOL",
            "state": "FL",
            "postal_code": "323210399",
            "telephone_number": "850-643-5866",
            "fax_number": "850-643-2866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY COUNTY AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PIPPIN",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "850-643-5866",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PARAMEDIC"
    },
    "taxonomies": [
        {
            "code": "146L00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Paramedic",
            "state": "FL",
            "license": "002611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.