City of Southaven

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

128 Issued in MS

Legal business name

CITY OF SOUTHAVEN

Doing business as

Southaven Fire Department Ambulance Service

Practice address

8710 Northwest Dr
Southaven, MS 38671-2410

Phone

(662) 393-7466

Fax

(662) 393-7294

NPI assigned

Sep 14, 2006

Organization subpart

No

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

Authorized official

Name

Leroy Bledsoe III

Title

Fire Chief

Phone

(662) 280-2489

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Southaven Fire Department Ambulance Service Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782864000000",
    "number": "1215033865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8710 NORTHWEST DR",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386712410",
            "telephone_number": "662-393-7466",
            "fax_number": "270-744-8642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8710 NORTHWEST DR",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386712410",
            "telephone_number": "662-393-7466",
            "fax_number": "662-393-7294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF SOUTHAVEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A",
        "authorized_official_last_name": "BLEDSOE",
        "authorized_official_first_name": "LEROY",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "662-280-2489",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MS",
            "license": "128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07774861",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "223862186",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southaven Fire Department Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Richard Christian, DNP
• Katie Patrick Christides, LCSW
• City Home Care, LLC
• City Home Care, LLC
• City Home Care, LLC
• Alisha Shavon Clark, PT
• Taylor Clark
• Katherine Clay, LBA
• Lauren Ashlea Clay
• Claycon LLC (Turning Point Recovery)

• Land Ambulance in Southaven, MS
• Providers in Southaven, MS by specialty
• Land Ambulance in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; 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.