Organization Active NPI

North Baltimore Village Office

Doing business as Village Of North Baltimore EMS

  • Ambulance
  • North Baltimore, OH
National Provider Identifier
1104856194
Registry record updated May 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
Legal business name
NORTH BALTIMORE VILLAGE OFFICE
Doing business as
Village Of North Baltimore EMS
Practice address
205 N. Main St
North Baltimore, OH 45872-1126
Phone
(419) 257-2394
Fax
(419) 257-2457
NPI assigned
Jul 4, 2006
Last updated
May 1, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTH BALTIMORE VILLAGE OFFICEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 1, 2012

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

Authorized official

Name
Mr. Kenneth A Yant
Title
Finance Officer
Phone
(419) 257-2394

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X NU
Ambulance 341600000X OH Primary

Addresses

Primary practice location

205 N. Main St
North Baltimore, OH 45872-1126

Mailing address

205 N. Main St
North Baltimore, OH 45872-1126
Phone (419) 257-2394

Other identifiers 1

IdentifierTypeStateIssuer
0373402MedicaidOH

Other names 1

  • Village Of North Baltimore EMS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120409000572 OH Part B Supplier - Ambulance Service Supplier 6305007964 Practice locations: North Baltimore, OH

National Provider Directory

National Provider Directory
Part of
North Baltimore Village Office

Locations

205 N Main St
North Baltimore, OH 45872
Phone (419) 257-2394

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335830400000",
    "number": "1104856194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N. MAIN ST",
            "city": "NORTH BALTIMORE",
            "state": "OH",
            "postal_code": "458721126",
            "telephone_number": "419-257-2394",
            "fax_number": "419-257-2457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N. MAIN ST",
            "city": "NORTH BALTIMORE",
            "state": "OH",
            "postal_code": "458721126",
            "telephone_number": "419-257-2394",
            "fax_number": "419-257-2457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH BALTIMORE VILLAGE OFFICE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH BALTIMORE VILLAGE OFFICE",
        "enumeration_date": "2006-07-04",
        "last_updated": "2012-05-01",
        "status": "A",
        "authorized_official_last_name": "YANT",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "FINANCE OFFICER",
        "authorized_official_telephone_number": "419-257-2394",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0373402",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Of North Baltimore EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Baltimore, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2012; 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.