City of Moundridge

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1350 Issued in KS

Legal business name

CITY OF MOUNDRIDGE

Doing business as

Moundridge EMS

Practice address

225 N Wedel Ave
Moundridge, KS 67107-7540

Phone

(620) 345-3657

Fax

(620) 345-3665

NPI assigned

Jan 26, 2007

Last updated

Nov 15, 2024By 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

Angie Vickrey

Title

Billing

Phone

(620) 345-3657

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Moundridge EMS Doing business as

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731628800000",
    "number": "1174679906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 N WEDEL AVE",
            "city": "MOUNDRIDGE",
            "state": "KS",
            "postal_code": "671077540",
            "telephone_number": "620-345-3657",
            "fax_number": "620-345-3665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 N WEDEL AVE",
            "city": "MOUNDRIDGE",
            "state": "KS",
            "postal_code": "671077540",
            "telephone_number": "620-345-3657",
            "fax_number": "620-345-3665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF MOUNDRIDGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A",
        "authorized_official_last_name": "VICKREY",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "620-345-3657"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "KS",
            "license": "1350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF KS",
            "identifier": "005643",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100091790A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moundridge EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cynthia L Bartell, RPT
• Vincent Astor Becker
• Kenneth Black
• CK Pharmacies LLC (CK Pharmacy - Moundridge LTC)
• CK Pharmacies LLC (CK Pharmacy - Moundridge)
• Michelle Claassen, PA
• Deona Cook, BS, LAC
• Rebecca Ann Dean, L.M., C.P.M.

• Land Ambulance in Moundridge, KS
• Providers in Moundridge, KS by specialty
• Land Ambulance in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; 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.

Verify at the official NPI Registry.