NPIMap

Organization Active NPI

County of Logan

  • Ambulance
  • Oakley, KS
National Provider Identifier
1205899499
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
1120 Issued in KS
Legal business name
COUNTY OF LOGAN
Practice address
703 W 3Rd St
Oakley, KS 67748-1269
Phone
(785) 671-0031
Fax
(785) 671-0031
NPI assigned
Apr 9, 2006
Last updated
May 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Authorized official

Name
Robert Kelly Jr.
Title
Director
Phone
(785) 672-1027

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 1120 KS Primary

Addresses

Primary practice location

703 W 3Rd St
Oakley, KS 67748-1269

Mailing address

710 W 2ND St
Oakley, KS 67748-1271
Phone (785) 672-1027

Other names 1

  • Logan County Emergency Medical Service Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120321000641 KS Part B Supplier - Ambulance Service Supplier 3476500620 Practice locations: Oakley, KS

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

  • County of Logan

    dba Logan County Health Department

    • Public Health or Welfare Agency
    • Oakley, KS
    • NPI 1124126719

    3476500620

    Same PAC ID

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
17D2129569Logan County EMS703 W 3Rd Street, Oakley, KS 67748Certificate of waiverApr 20, 2027

National Provider Directory

National Provider Directory
Tax ID family
Logan County Health Dep3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

710 W 2nd St
Oakley, KS 67748

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Reliant Pro RehabOakley, KS, CCN 175567 Skilled nursing facility Adp of the SNF Jul 1, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1144540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716163200000",
    "number": "1205899499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 W 2ND ST",
            "city": "OAKLEY",
            "state": "KS",
            "postal_code": "677481271",
            "telephone_number": "785-672-1027",
            "fax_number": "785-672-0031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 W 3RD ST",
            "city": "OAKLEY",
            "state": "KS",
            "postal_code": "677481269",
            "telephone_number": "785-671-0031",
            "fax_number": "785-671-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF LOGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-09",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "785-672-1027",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "KS",
            "license": "1120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Logan County Emergency Medical Service",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oakley, KS

Sources for this page

Verify at the official NPI Registry.