NPIMap

Organization Active NPI

City of Etna

Doing business as City of Etna Ambulance

  • Land Ambulance
  • Etna, CA
National Provider Identifier
1124024070
Registry record updated Oct 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
CITY OF ETNA
Doing business as
City of Etna Ambulance
Practice address
442 Main St
Etna, CA 96027
Phone
(530) 467-3217
NPI assigned
Jun 24, 2005
Last updated
Oct 18, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2016

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

Authorized official

Name
Sarah Griggs
Title
City Clerk
Phone
(530) 467-3217

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

442 Main St
Etna, CA 96027

Mailing address

PO Box 269110
Sacramento, CA 95826-9110

Other names 1

  • City of Etna Ambulance Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120312000222 CA Part B Supplier - Ambulance Service Supplier 1759540750 Practice locations: Etna, CA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476748800000",
    "number": "1124024070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 269110",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958269110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 MAIN ST",
            "city": "ETNA",
            "state": "CA",
            "postal_code": "96027",
            "telephone_number": "530-467-3217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF ETNA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-24",
        "last_updated": "2016-10-18",
        "status": "A",
        "authorized_official_last_name": "GRIGGS",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "CITY CLERK",
        "authorized_official_telephone_number": "530-467-3217"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "City of Etna Ambulance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Etna, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; 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.