Active NPI
City of Bridgeport
- Land Ambulance
- Bridgeport, WA
National Provider Identifier
1275718322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 09M01
- Legal business name
- CITY OF BRIDGEPORT
- Practice address
- 1206 Columbia Avenue
Bridgeport, WA 98813-0640 - Phone
- (509) 686-4041
- Fax
- (509) 686-2828
- NPI assigned
- Jan 8, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Ruth J Asmussen-Brown
- Title
- City Administrator
- Phone
- (509) 686-4041
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 09M01 | WA | Primary |
Addresses
Primary practice location
1206 Columbia Avenue
Bridgeport, WA 98813-0640
Mailing address
PO Box 640
1206 Columbia Avenue
Bridgeport, WA 98813-0640
Phone (509) 686-4041
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081009000187 | WA | Part B Supplier - Ambulance Service Supplier | 1153499728 | Practice locations: Bridgeport, WA |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199750400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1739232000000",
"number": "1275718322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 640",
"address_2": "1206 COLUMBIA AVENUE",
"city": "BRIDGEPORT",
"state": "WA",
"postal_code": "988130640",
"telephone_number": "509-686-4041",
"fax_number": "509-686-2828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1206 COLUMBIA AVENUE",
"city": "BRIDGEPORT",
"state": "WA",
"postal_code": "988130640",
"telephone_number": "509-686-4041",
"fax_number": "509-686-2828"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CITY OF BRIDGEPORT",
"organizational_subpart": "NO",
"enumeration_date": "2008-01-08",
"last_updated": "2025-02-11",
"certification_date": "2025-02-11",
"status": "A",
"authorized_official_last_name": "ASMUSSEN-BROWN",
"authorized_official_first_name": "RUTH",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "CITY ADMINISTRATOR",
"authorized_official_telephone_number": "509-686-4041",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "WA",
"license": "09M01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgeport, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; 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.