Active NPI
City of Kellogg
Doing business as Kellogg Fire Dept.
- Land Ambulance
- Kellogg, IA
National Provider Identifier
1215909411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- Legal business name
- CITY OF KELLOGG
- Doing business as
- Kellogg Fire Dept.
- Practice address
- 417 Front St
Kellogg, IA 50135-1162 - Phone
- (641) 526-3051
- NPI assigned
- Feb 2, 2006
- Last updated
- Jul 14, 2008
- 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
- Mr. Dennis W Stevenson
- Title
- Deputy Chief
- Phone
- (641) 526-3051
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | NU | Primary |
Addresses
Primary practice location
417 Front St
Kellogg, IA 50135-1162
Mailing address
417 Front St.
P.O. Box 278
Kellogg, IA 50135-0278
Phone (641) 526-3051
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0170738 | Other | IOWA MEDICAD ENTERPRISE | |
| 0170738 | Medicaid | IA | |
| 50915 | Other | BCBS | |
| 590012456 | Other | IA | MEDICARE RAILROAD |
| 0170738 | Other | HERIT AGE JOHN DEERE |
Other names 1
- Kellogg Fire Dept.
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080229000504 | IA | Part B Supplier - Ambulance Service Supplier | 8325122245 | Practice locations: Kellogg, IA |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Emergency Medicine Physician
- Marshalltown, IA
- NPI 1417818402
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138838400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1215993600000",
"number": "1215909411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "417 FRONT ST.",
"address_2": "P.O. BOX 278",
"city": "KELLOGG",
"state": "IA",
"postal_code": "501350278",
"telephone_number": "641-526-3051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "417 FRONT ST",
"city": "KELLOGG",
"state": "IA",
"postal_code": "501351162",
"telephone_number": "641-526-3051"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CITY OF KELLOGG",
"organizational_subpart": "NO",
"enumeration_date": "2006-02-02",
"last_updated": "2008-07-14",
"status": "A",
"authorized_official_last_name": "STEVENSON",
"authorized_official_first_name": "DENNIS",
"authorized_official_middle_name": "W",
"authorized_official_title_or_position": "DEPUTY CHIEF",
"authorized_official_telephone_number": "641-526-3051",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IOWA MEDICAD ENTERPRISE",
"identifier": "0170738",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0170738",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "50915",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "590012456",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HERIT AGE JOHN DEERE",
"identifier": "0170738",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Kellogg Fire Dept.",
"code": "3",
"type": "Doing Business As"
}
]
}
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; 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.