NPIMap

Organization Active NPI

Lacon Sparland Emergency 52

  • Land Ambulance
  • Lacon, IL
National Provider Identifier
1194893578
Registry record updated Jan 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
02 2527 Issued in IL
Legal business name
LACON SPARLAND EMERGENCY 52
Practice address
921 5TH St
Lacon, IL 61540-1315
Phone
(309) 246-4095
NPI assigned
Dec 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2013

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

Authorized official

Name
Kimberly Borquist
Title
Director
Phone
(309) 246-4095

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 02 2527 IL Primary

Addresses

Primary practice location

921 5TH St
Lacon, IL 61540-1315

Mailing address

PO Box 52
Lacon, IL 61540-0052
Phone (309) 246-4095

Other names 1

  • LACON SPARLAND EMERGENCY AMBULANCE SERVICE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051025000498 IL Part B Supplier - Ambulance Service Supplier 3779500251 Practice locations: Lacon, IL

National Provider Directory

National Provider Directory

Locations

125 N Main St
Lacon, IL 61540

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357689600000",
    "number": "1194893578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52",
            "city": "LACON",
            "state": "IL",
            "postal_code": "615400052",
            "telephone_number": "309-246-4095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 5TH ST",
            "city": "LACON",
            "state": "IL",
            "postal_code": "615401315",
            "telephone_number": "309-246-4095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LACON SPARLAND EMERGENCY 52",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2013-01-09",
        "status": "A",
        "authorized_official_last_name": "BORQUIST",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "309-246-4095"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "02 2527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LACON SPARLAND EMERGENCY AMBULANCE SERVICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lacon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2013; 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.