North Henderson County Ambulance Service Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1770778 Issued in IL

Legal business name

NORTH HENDERSON COUNTY AMBULANCE SERVICE INC.

Practice address

411 Warren St
Oquawka, IL 61469

Phone

(309) 867-2452

NPI assigned

Mar 16, 2007

Last updated

Feb 6, 2012By 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

Mr. Troy Jern, DIRECTOR

Title

Director

Phone

(319) 752-4032

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328486400000",
    "number": "1144354432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 866",
            "city": "OQUAWKA",
            "state": "IL",
            "postal_code": "614690866",
            "telephone_number": "309-867-2452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 WARREN ST",
            "city": "OQUAWKA",
            "state": "IL",
            "postal_code": "61469",
            "telephone_number": "309-867-2452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH HENDERSON COUNTY AMBULANCE SERVICE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2012-02-06",
        "status": "A",
        "authorized_official_last_name": "JERN",
        "authorized_official_first_name": "TROY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "319-752-4032",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DIRECTOR"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "1770778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rola Kim, DMD
• Jonathan Lindo, MD
• Emilyrae Matsko
• Jessica Lynn McKee, RDH PHDH
• Shannon Kelly Miller, RDH
• Crystal Ann Simpson, DMD
• Jordanne Twigg
• Shannon Vanzummeren, APN

• Land Ambulance in Oquawka, IL
• Providers in Oquawka, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.