Lifeteam EMS Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

150012 Issued in OH

Legal business name

LIFETEAM EMS INC

Practice address

7100 Whipple Ave NW
Ste E
North Canton, OH 44720-7167

Phone

(330) 386-5606

Fax

(330) 232-9917

NPI assigned

Aug 12, 2005

Organization subpart

No

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

Authorized official

Name

Kenneth J Joseph

Title

Chief Executive Officer

Phone

(330) 323-4800

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720137600000",
    "number": "1225030869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 WHIPPLE AVE NW",
            "address_2": "STE E",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447207167",
            "telephone_number": "330-386-5606",
            "fax_number": "330-232-9917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 WHIPPLE AVE NW",
            "address_2": "STE E",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447207167",
            "telephone_number": "330-386-5606",
            "fax_number": "330-232-9917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETEAM EMS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-12",
        "last_updated": "2024-07-05",
        "status": "A",
        "authorized_official_last_name": "JOSEPH",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "330-323-4800"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OH",
            "license": "150012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1041716",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590004050",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0144560000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0668013",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMPENSATION",
            "identifier": "1013108",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0083370",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Malorie K Libal, LPTA
• Matthew Licause, MD
• Brandon Gregory Liebau, MD
• Lifeline Partners of Canton, Inc
• Lifeline Partners Sleep & Diagnostic Center, Inc
• Danielle Lightell
• Jerry N Liliestedt, R.PH.
• Bernadette Lilly, OTR/L
• Michelle L Limbert, CCC-SLP
• Agatha Limpach, COTA/L

• Land Ambulance in North Canton, OH
• Providers in North Canton, OH by specialty
• Land Ambulance in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2024; 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.