NPIMap

Organization Active NPI

Shelby Area Ambulance Service

  • Ambulance
  • Shelbyville, IL
National Provider Identifier
1275537805
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
6-6710 Issued in IL
Legal business name
SHELBY AREA AMBULANCE SERVICE
Practice address
310 N Cedar St
Shelbyville, IL 62565-1000
Phone
(217) 774-2608
NPI assigned
Jun 10, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jeanne R Coventry, PA
Title
President
Phone
(217) 774-2608

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 6-6710 IL Primary

Addresses

Primary practice location

310 N Cedar St
Shelbyville, IL 62565-1000

Mailing address

310 N Cedar St
Shelbyville, IL 62565-1000
Phone (217) 774-2608

Other identifiers 1

IdentifierTypeStateIssuer
8721485OtherILBCBSIL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275537805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N CEDAR ST",
            "city": "SHELBYVILLE",
            "state": "IL",
            "postal_code": "625651000",
            "telephone_number": "217-774-2608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N CEDAR ST",
            "city": "SHELBYVILLE",
            "state": "IL",
            "postal_code": "625651000",
            "telephone_number": "217-774-2608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELBY AREA AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COVENTRY",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-774-2608",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "IL",
            "license": "6-6710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIL",
            "identifier": "8721485",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.