Active NPI
City of St. Clair Shores
- Land Ambulance
- St. Clair Shores, MI
National Provider Identifier
1174561104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- Legal business name
- CITY OF ST. CLAIR SHORES
- Practice address
- 26700 Harper Avenue
St. Clair Shores, MI 48081-1953 - Phone
- (586) 445-5380
- NPI assigned
- Jun 3, 2006
- 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
- James Piper
- Title
- Fire Chief
- Phone
- (586) 445-5380
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | Primary |
Addresses
Primary practice location
26700 Harper Avenue
St. Clair Shores, MI 48081-1953
Mailing address
PO Box 2122
Riverview, MI 48193-1122
Phone (009) 266-9858
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 183000846 | Medicaid | MI |
Other names 1
- St. Clair Shores Fire Department
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111116000717 | MI | Part B Supplier - Ambulance Service Supplier | 1759555352 | Practice locations: Saint Clair Shores, MI; St Clair Shores, MI |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D1081812 | City of St Clair Shores Fire Dept | Certificate of waiver | Mar 25, 2028 |
National Provider Directory
National Provider DirectoryLocations
26700 Harper Ave
Saint Clair Shores, MI 48081
Phone (586) 445-5380
23815 Greater Mack Ave
St Clr Shores, MI 48080
Phone (586) 445-5380
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149292800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1689897600000",
"number": "1174561104",
"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": "009-266-9858",
"fax_number": "734-479-6319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26700 HARPER AVENUE",
"city": "ST. CLAIR SHORES",
"state": "MI",
"postal_code": "480811953",
"telephone_number": "586-445-5380"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CITY OF ST. CLAIR SHORES",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-03",
"last_updated": "2023-07-21",
"certification_date": "2023-07-21",
"status": "A",
"authorized_official_last_name": "PIPER",
"authorized_official_first_name": "JAMES",
"authorized_official_title_or_position": "FIRE CHIEF",
"authorized_official_telephone_number": "586-445-5380"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "183000846",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "St. Clair Shores Fire Department",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "St. Clair Shores Fire Department",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in St. Clair Shores, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.