Active NPI
Star Volunteers
- Ambulance
- Channing, MI
National Provider Identifier
1114915253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulance
- License
- 221003
- Legal business name
- STAR VOLUNTEERS
- Practice address
- 503 6TH St
Channing, MI 49815-0161 - Phone
- (906) 542-9411
- NPI assigned
- Oct 12, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Cory Michael Roell
- Title
- President
- Phone
- (906) 221-7718
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | 221003 | MI | Primary |
Addresses
Primary practice location
503 6TH St
Channing, MI 49815-0161
Mailing address
PO Box 161
503 6TH St
Channing, MI 49815-0161
Phone (906) 542-9411
Other names 1
- Star Ambulance Service
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081007000373 | MI | Part B Supplier - Ambulance Service Supplier | 8224106026 | Practice locations: Channing, MI |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129075200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1715558400000",
"number": "1114915253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 161",
"address_2": "503 6TH ST",
"city": "CHANNING",
"state": "MI",
"postal_code": "498150161",
"telephone_number": "906-542-9411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "503 6TH ST",
"city": "CHANNING",
"state": "MI",
"postal_code": "498150161",
"telephone_number": "906-542-9411"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STAR VOLUNTEERS",
"organizational_subpart": "NO",
"enumeration_date": "2005-10-12",
"last_updated": "2024-05-13",
"certification_date": "2024-05-13",
"status": "A",
"authorized_official_last_name": "ROELL",
"authorized_official_first_name": "CORY",
"authorized_official_middle_name": "MICHAEL",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "906-221-7718"
},
"taxonomies": [
{
"code": "341600000X",
"taxonomy_group": "",
"desc": "Ambulance",
"state": "MI",
"license": "221003",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Star Ambulance Service",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Star Ambulance Service",
"code": "3",
"type": "Doing Business As"
}
]
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; 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.