NPIMap

Organization Active NPI

Pafford Emergency Medical Services, Inc

Doing business as Pafford Air One

  • Ambulance
  • Clarksdale, MS
National Provider Identifier
1235498221
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
Legal business name
PAFFORD EMERGENCY MEDICAL SERVICES, INC
Doing business as
Pafford Air One
Practice address
2610 N State St
Clarksdale, MS 38614-6101
Phone
(800) 451-8036
Fax
(870) 777-8479
NPI assigned
May 10, 2012
Organization subpart
Yes
Parent organization
PAFFORD EMERGENCY MEDICAL SERVICES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Authorized official

Name
Mr. Larry D Clark
Title
C.C.O.
Phone
(800) 451-8036

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X Primary
Air Ambulance 3416A0800X
Land Ambulance 3416L0300X

Addresses

Primary practice location

2610 N State St
Clarksdale, MS 38614-6101

Mailing address

PO Box 1120
Hope, AR 71802-1120
Phone (800) 451-8036

Other identifiers 3

IdentifierTypeStateIssuer
2604848MedicaidLA
194030715MedicaidAR
03174249MedicaidMS

Other names 1

  • PAFFORD AIR ONE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120717000197 MS Part B Supplier - Ambulance Service Supplier 9931245081 Practice locations: Vicksburg, MS; Yazoo City, MS; Starkville, MS; Ridgeland, MS; Pearl, MS; Leland, MS; Hollandale, MS; Greenville, MS…

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Pafford Emergency Medical Services Inc

Locations

2610 N State St
#One
Clarksdale, MS 38614

NPI Registry JSON

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

{
    "created_epoch": "1336608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680480000000",
    "number": "1235498221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1120",
            "city": "HOPE",
            "state": "AR",
            "postal_code": "718021120",
            "telephone_number": "800-451-8036",
            "fax_number": "870-777-8479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2610 N STATE ST",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386146101",
            "telephone_number": "800-451-8036",
            "fax_number": "870-777-8479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAFFORD EMERGENCY MEDICAL SERVICES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PAFFORD EMERGENCY MEDICAL SERVICES, INC",
        "enumeration_date": "2012-05-10",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "C.C.O.",
        "authorized_official_telephone_number": "800-451-8036",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3416A0800X",
            "taxonomy_group": "",
            "desc": "Ambulance, Air Transport",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2604848",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "194030715",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03174249",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PAFFORD AIR ONE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PAFFORD AIR ONE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarksdale, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; 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.