Williamson County Ambulance Service, Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

5210 Issued in IL

Legal business name

WILLIAMSON COUNTY AMBULANCE SERVICE, INC

Practice address

808 E Deyoung St
Marion, IL 62959-3333

Phone

(618) 997-4915

Fax

(618) 993-3386

NPI assigned

Oct 10, 2006

Organization subpart

No

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

Authorized official

Name

Ricky L Colyer

Title

President

Phone

(618) 922-8670

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564358400000",
    "number": "1255428140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 E DEYOUNG ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629593333",
            "telephone_number": "618-997-4915",
            "fax_number": "618-993-3386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 E DEYOUNG ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629593333",
            "telephone_number": "618-997-4915",
            "fax_number": "618-993-3386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMSON COUNTY AMBULANCE SERVICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2019-07-29",
        "status": "A",
        "authorized_official_last_name": "COLYER",
        "authorized_official_first_name": "RICKY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-922-8670"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "5210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "027487",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK, INC",
            "identifier": "113139",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL BLACK LUNG",
            "identifier": "087931100",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "10070554",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590155539",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "8181435",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeff Williams
• Lindsay Marie Williams
• Maura Kathleen Williams, COTA/L
• Nicole Williams, FNP
• Williamson Co. Special Education District
• Williamson County Special Ed
• Byron R Williamson, DO
• Caitlin Elizabeth Williford
• Deborah Wills, MS
• Charles Keith Wilson, R PH

• Land Ambulance in Marion, IL
• Providers in Marion, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2019; 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.