Sargent County Ambulance Forman Squad

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

SARGENT COUNTY AMBULANCE FORMAN SQUAD

Doing business as

Sargent County Ambulance Forman
Sargent County Ambulance

Practice address

355 Main St S
Forman, ND 58032

Phone

(701) 724-6241

NPI assigned

Oct 20, 2006

Last updated

Nov 19, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Trent Mahler

Title

Coordinator

Phone

(701) 724-6241

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 2

• SARGENT COUNTY AMBULANCE FORMAN Doing business as
• Sargent County Ambulance Doing business as

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Maddock Ambulance Service

  • Land Ambulance
  • Maddock, ND
  • NPI 1760539100

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Darci Weber

  • Social Worker
  • Fargo, ND
  • NPI 1518371327
  NPD (past)

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1265514756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 316",
            "city": "FORMAN",
            "state": "ND",
            "postal_code": "580320316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 MAIN ST S",
            "city": "FORMAN",
            "state": "ND",
            "postal_code": "58032",
            "telephone_number": "701-724-6241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SARGENT COUNTY AMBULANCE FORMAN SQUAD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "MAHLER",
        "authorized_official_first_name": "TRENT",
        "authorized_official_title_or_position": "COORDINATOR",
        "authorized_official_telephone_number": "701-724-6241"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "ND",
            "license": "040",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "7298",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50033",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SARGENT COUNTY AMBULANCE FORMAN",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sargent County Ambulance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michele H Gilbertson
• Kari Gilje, LSW
• Rosanne Clare Lohman, NP-C
• Kelsy Martinson, PHARMD
• Sanford Medical Center Fargo (Sanford Health Forman Clinic)
• Sargent County Social Services
• Nathan Wilbur Schlecht, R.PH.
• Southeast Therapy Services Inc

• Land Ambulance in Forman, ND
• Providers in Forman, ND by specialty
• Land Ambulance in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.