Active NPI
Evergreen Fire Protection District
- Land Ambulance
- Evergreen, CO
National Provider Identifier
1184734915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- Legal business name
- EVERGREEN FIRE PROTECTION DISTRICT
- Practice address
- 1802 Bergen Parkway
Evergreen, CO 80439 - Phone
- (303) 679-4747
- Fax
- (303) 674-8701
- NPI assigned
- Aug 30, 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
- David J Montesi, NREMTP
- Title
- EMS Division Chief
- Phone
- (303) 679-4753
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | CO | Primary |
Addresses
Primary practice location
1802 Bergen Parkway
Evergreen, CO 80439
Mailing address
1802 Bergen Parkway
Evergreen, CO 80439
Phone (303) 679-4747
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06614838 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051205000520 | CO | Part B Supplier - Ambulance Service Supplier | 1355361452 | Practice locations: Evergreen, CO |
National Provider Directory
National Provider Directory- Tax ID family
- Evergreen Fire Protection District
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Land Ambulance
- Evergreen, CO
- NPI 1538765011
Locations
1802 Bergen Pkwy
Evergreen, CO 80439
Phone (303) 674-3145
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1607299200000",
"number": "1184734915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1802 BERGEN PARKWAY",
"city": "EVERGREEN",
"state": "CO",
"postal_code": "80439",
"telephone_number": "303-679-4747",
"fax_number": "303-674-8701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1802 BERGEN PARKWAY",
"city": "EVERGREEN",
"state": "CO",
"postal_code": "80439",
"telephone_number": "303-679-4747",
"fax_number": "303-674-8701"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EVERGREEN FIRE PROTECTION DISTRICT",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-30",
"last_updated": "2020-12-07",
"certification_date": "2020-12-07",
"status": "A",
"authorized_official_last_name": "MONTESI",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "EMS DIVISION CHIEF",
"authorized_official_telephone_number": "303-679-4753",
"authorized_official_credential": "NREMTP"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "CO",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "06614838",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Evergreen, CO
- Sarah Evans, PT
- Evergreen Counseling and Wellness
- Evergreen Dental Group
- Evergreen Dental Partners LLP (Comfort Dental Evergreen)
- Evergreen Family Dentistry PC
- Evergreen Fire Protection District
- Evergreen Meadows Family Medical Center
- Evergreen Medical Acupuncture LLC
- Evergreen Operations, LLC (Life Care Center of Evergreen)
- Evergreen Oral and Maxillofacial Surgery
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; 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.