NPIMap

Organization Active NPI

Whitesville Ambulance Service, Inc.

  • Land Ambulance
  • Whitesville, WV
National Provider Identifier
1225183718
Registry record updated Sep 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
NO NUMBER Issued in WV
Legal business name
WHITESVILLE AMBULANCE SERVICE, INC.
Practice address
700 Raleigh Street
Whitesville, WV 25209
Phone
(304) 854-1197
NPI assigned
Jan 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2011

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

Authorized official

Name
Lisa Ford
Title
Office Manager
Phone
(304) 854-1197

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X NO NUMBER WV Primary

Addresses

Primary practice location

700 Raleigh Street
Whitesville, WV 25209

Mailing address

PO Box 145
Whitesville, WV 25209-0145
Phone (304) 854-1197

Other identifiers 1

IdentifierTypeStateIssuer
0145605000MedicaidWV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080602000344 WV Part B Supplier - Ambulance Service Supplier 5597835686 Practice locations: Whitesville, WV

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314921600000",
    "number": "1225183718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 145",
            "city": "WHITESVILLE",
            "state": "WV",
            "postal_code": "252090145",
            "telephone_number": "304-854-1197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 RALEIGH STREET",
            "city": "WHITESVILLE",
            "state": "WV",
            "postal_code": "25209",
            "telephone_number": "304-854-1197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITESVILLE AMBULANCE SERVICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2011-09-02",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "304-854-1197"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WV",
            "license": "NO NUMBER",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0145605000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitesville, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2011; 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.