City of Williston

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

131 Issued in ND

Legal business name

CITY OF WILLISTON

Doing business as

Williston Ambulance Service

Practice address

317 11TH St W
Williston, ND 58801

Phone

(701) 572-3400

Fax

(701) 572-6602

NPI assigned

May 10, 2007

Last updated

Mar 1, 2021By 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

Hercules Cummings

Title

Finance Director

Phone

(701) 572-3400

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• WILLISTON AMBULANCE SERVICE Doing business as

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Tax ID family

Williston Amb SVC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• City of Williston

  • Ambulance
  • Williston, ND
  • NPI 1396842332
  NPD tax ID

Locations

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614556800000",
    "number": "1174737712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 11TH STREET W",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588015127",
            "telephone_number": "701-572-3400",
            "fax_number": "701-572-6602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 11TH ST W",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "58801",
            "telephone_number": "701-572-3400",
            "fax_number": "701-572-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF WILLISTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A",
        "authorized_official_last_name": "CUMMINGS",
        "authorized_official_first_name": "HERCULES",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "701-572-3400"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "ND",
            "license": "131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1451862",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ND",
            "identifier": "8375",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "440700",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER INSURANCE",
            "identifier": "7008",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WILLISTON AMBULANCE SERVICE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WILLISTON AMBULANCE SERVICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• CHI Health Connect at Home-Fargo (CHI Health at Home)
• CHI Health Connect at Home-Fargo (CHI Health at Home)
• Choice Recovery Counseling, PLLC
• Chelsea Rose Christie, LBSW
• Therresa Christopherson
• City of Williston
• John Madison Clair, DO
• Christina Clark, CERTIFIED MHT
• Danilynn Marie Clark, LAC
• Leeann Clark

• Land Ambulance in Williston, ND
• Providers in Williston, ND by specialty
• Land Ambulance in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; 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.