City of Grand Island

Primary specialty

AmbulanceTaxonomy code 341600000X

License

5022 Issued in NE

Legal business name

CITY OF GRAND ISLAND

Doing business as

Grand Island Fire Department

Practice address

100 E 1St St
Grand Island, NE 68801-6023

Phone

(308) 385-5444

Fax

(308) 385-5423

NPI assigned

Jul 9, 2006

Last updated

Aug 8, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Russell M Blackburn Jr.

Title

EMS Division Chief

Phone

(308) 389-0227

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Grand Island Fire Department Doing business as

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Locations

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533686400000",
    "number": "1093748212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1968",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688021968",
            "telephone_number": "308-385-5444",
            "fax_number": "308-385-5423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E 1ST ST",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688016023",
            "telephone_number": "308-385-5444",
            "fax_number": "308-385-5423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF GRAND ISLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2018-08-08",
        "status": "A",
        "authorized_official_last_name": "BLACKBURN",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EMS DIVISION CHIEF",
        "authorized_official_telephone_number": "308-389-0227",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NE",
            "license": "5022",
            "primary": true
        },
        {
            "code": "146L00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Paramedic",
            "state": "NE",
            "license": "5022",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMCR",
            "identifier": "590121529",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Island Fire Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Douglas L Clark, MD
• Pamela A Clausen, LMHP

• Ambulance in Grand Island, NE
• Providers in Grand Island, NE by specialty
• Ambulance in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2018; 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.