Organization Active NPI

Washington County-Johnson City Emergency Medical Services Inc

  • Land Ambulance
  • Johnson City, TN
National Provider Identifier
1184633679
Registry record updated Jan 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
EMS0000009001 Issued in TN
Legal business name
WASHINGTON COUNTY-JOHNSON CITY EMERGENCY MEDICAL SERVICES INC
Practice address
296 Wesley St
Johnson City, TN 37601-1720
Phone
(423) 975-5500
Fax
(423) 975-5505
NPI assigned
Aug 5, 2006
Last updated
Jan 24, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lori Kemp, CPA
Title
Comptroller
Phone
(423) 975-5500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X EMS0000009001 TN Primary

Addresses

Primary practice location

296 Wesley St
Johnson City, TN 37601-1720

Mailing address

PO Box 5928
Johnson City, TN 37602-5928
Phone (844) 347-1063

Other identifiers 1

IdentifierTypeStateIssuer
4110024OtherTNBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060829000031 TN Part B Supplier - Ambulance Service Supplier 9032113329 Practice locations: Johnson City, TN

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D0939533Washington County-Johnson City296 Wesley Street, Johnson City, TN 37601Certificate of waiverJan 27, 2028

National Provider Directory

National Provider Directory

Locations

296 Wesley St
Johnson City, TN 37601
Phone (423) 975-5500

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485216000000",
    "number": "1184633679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5928",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376025928",
            "telephone_number": "844-347-1063",
            "fax_number": "888-974-1293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "296 WESLEY ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011720",
            "telephone_number": "423-975-5500",
            "fax_number": "423-975-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON COUNTY-JOHNSON CITY EMERGENCY MEDICAL SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2017-01-24",
        "status": "A",
        "authorized_official_last_name": "KEMP",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "COMPTROLLER",
        "authorized_official_telephone_number": "423-975-5500",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "TN",
            "license": "EMS0000009001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4110024",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2017; 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.