NPIMap

Organization Active NPI

Franciscan Health Lafayette

  • Land Ambulance
  • Lafayette, IN
National Provider Identifier
1245569144
Registry record updated Apr 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
0007 Issued in IN
Legal business name
FRANCISCAN HEALTH LAFAYETTE
Practice address
1501 Hartford St
Lafayette, IN 47904-2134
Phone
(765) 449-3152
Fax
(765) 449-3117
NPI assigned
Dec 24, 2009
Last updated
Apr 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2021

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

Authorized official

Name
Terrance E. Wilson
Title
Ceo
Phone
(765) 502-4440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 0007 IN Primary

Addresses

Primary practice location

1501 Hartford St
Lafayette, IN 47904-2134

Mailing address

1501 Hartford St
Lafayette, IN 47904-2134
Phone (765) 423-6276

Other names 1

  • Tippecanoe Emergency Ambulance Service Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100201000389 IN Part B Supplier - Ambulance Service Supplier 6204747470 Practice locations: Lafayette, IN; West Lafayette, IN

Other NPIs with the same Medicare PAC ID 7

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

National Provider Directory

National Provider Directory
Tax ID family
Franciscan Health Lafayette24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Franciscan Home CareCrawfordsville, IN, CCN 157124 Home health agency Operational/Managerial Control (100%) Oct 12, 2011

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1261612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618531200000",
    "number": "1245569144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 HARTFORD ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042134",
            "telephone_number": "765-423-6276",
            "fax_number": "765-423-6049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 HARTFORD ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042134",
            "telephone_number": "765-449-3152",
            "fax_number": "765-449-3117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANCISCAN HEALTH LAFAYETTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-24",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "TERRANCE",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "765-502-4440"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IN",
            "license": "0007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tippecanoe Emergency Ambulance Service",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Tippecanoe Emergency Ambulance Service",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.