Organization Active NPI

City of Kellogg

Doing business as Kellogg Fire Dept.

  • Land Ambulance
  • Kellogg, IA
National Provider Identifier
1215909411
Registry record updated Jul 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
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, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2008

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0170738OtherIOWA MEDICAD ENTERPRISE
0170738MedicaidIA
50915OtherBCBS
590012456OtherIAMEDICARE RAILROAD
0170738OtherHERIT AGE JOHN DEERE

Other names 1

  • Kellogg Fire Dept. Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080229000504 IA Part B Supplier - Ambulance Service Supplier 8325122245 Practice locations: Kellogg, IA

National Provider Directory

National Provider Directory

Practitioners & 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.

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.

Verify at the official NPI Registry.