Lincoln Medical Center Ambulance Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

LINCOLN MEDICAL CENTER AMBULANCE SERVICE

Practice address

106 Medical Center Blvd
Fayetteville, TN 37334-2684

Phone

(931) 438-7434

NPI assigned

Jun 5, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Darrell Blaylock

Title

Ceo

Phone

(931) 438-7455

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1401926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632355200000",
    "number": "1235542333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9150",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420029150",
            "telephone_number": "270-744-9600",
            "fax_number": "270-744-0834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 MEDICAL CENTER BLVD",
            "city": "FAYETTEVILLE",
            "state": "TN",
            "postal_code": "373342684",
            "telephone_number": "931-438-7434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN MEDICAL CENTER AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-05",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A",
        "authorized_official_last_name": "BLAYLOCK",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "931-438-7455",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "TN",
            "license": "0000005201",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1534346",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01475369",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lincoln County Vision Center
• Lincoln Ear Nose and Throat
• Lincoln Medical Center
• Lincoln Medical Center
• Lincoln Medical Center
• Lincoln Medical Center Cardiology Clinic
• Lincoln Medical Center Hospitalist
• Lincoln Medical Center OBGYN Clinic
• Lincoln Medical Center Orthopedic Clinic
• Lincoln Medical Center Orthopedic Clinic

• Land Ambulance in Fayetteville, TN
• Providers in Fayetteville, TN by specialty
• Land Ambulance in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.