Northern Light Medical Transport

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

NORTHERN LIGHT MEDICAL TRANSPORT

Practice address

931 Union St
Bangor, ME 04401-3011

Phone

(207) 973-4700

Fax

(207) 973-4713

NPI assigned

Jun 15, 2018

Last updated

Jun 15, 2018By 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. Joseph Clark Kellner

Title

VP Emer Services and Comm Progs

Phone

(207) 973-4702

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Locations

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

{
    "created_epoch": "1529020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529020800000",
    "number": "1174017941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WHITING HILL RD",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121005",
            "telephone_number": "207-973-4702",
            "fax_number": "207-973-4713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 UNION ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013011",
            "telephone_number": "207-973-4700",
            "fax_number": "207-973-4713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN LIGHT MEDICAL TRANSPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-15",
        "last_updated": "2018-06-15",
        "status": "A",
        "authorized_official_last_name": "KELLNER",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "CLARK",
        "authorized_official_title_or_position": "VP EMER SERVICES AND COMM PROGS",
        "authorized_official_telephone_number": "207-973-4702",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Bangor, ME
• Providers in Bangor, ME by specialty
• Land Ambulance in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2018; 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.