City of Elkhart

Key facts

NPI

1114072964

Entity type

Organization (NPI type 2)

Primary specialty

Ambulance 341600000X

License

0135 (IN)

Legal business name

CITY OF ELKHART

Practice address

500 East St
Elkhart, IN 46516-3610

Phone

(734) 253-0103

Fax

(574) 522-1023

NPI assigned

Jan 24, 2007

Organization subpart

No

Authorized official

Name

Mr. Shaun Edgerton

Title

Assistant Chief of Operations

Phone

(574) 293-8931

Corporate family (same tax ID) 1

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

• City of Elkhart Ambulance · Elkhart, IN · NPI 1891746681
  NPD tax ID

Medicare participation

Medicare fee-for-service enrollment

Enrolled in IN

Medicare enrollment records

National Provider Directory

Tax ID family

City of Elkhart (2 organizations share this tax ID)

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 14, 2025.

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763078400000",
    "number": "1114072964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2122",
            "city": "RIVERVIEW",
            "state": "MI",
            "postal_code": "481931122",
            "telephone_number": "800-926-6985",
            "fax_number": "336-510-5894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 EAST ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465163610",
            "telephone_number": "734-253-0103",
            "fax_number": "574-522-1023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF ELKHART",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A",
        "authorized_official_last_name": "EDGERTON",
        "authorized_official_first_name": "SHAUN",
        "authorized_official_title_or_position": "ASSISTANT CHIEF OF OPERATIONS",
        "authorized_official_telephone_number": "574-293-8931",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "IN",
            "license": "0135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000000199574",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590014821",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200269490A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

• John Chung, MD
• Deanna Chupp, MSW
• Amelia Chuppe, OTR/L
• Mary Ann Cintron
• Christine Marie Cisneros, M.D.
• City of Elkhart
• City Optical Co., Inc.
• Elizabeth Ciupinski
• Meghan Clairday
• Benjamin Jacob Clark, CRNA

All providers in Elkhart, IN · Ambulance in Indiana