City of Excelsior Springs

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

CITY OF EXCELSIOR SPRINGS

Doing business as

Excelsior Springs Fire Department

Practice address

1120 Tracy Ave.
Excelsior Springs, MO 64024-1141

Phone

(816) 630-3000

Fax

(816) 630-9530

NPI assigned

May 24, 2005

Last updated

Apr 1, 2022By 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

Zachary St John

Title

Asst. Chief

Phone

(816) 630-3000

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Excelsior Springs Fire Department Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

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 organizations 3

Organizations listed as members of this organization in the National Provider Directory.

• Excelsior Springs City Hospital

  dba Lawson Primary Care

  • Rural Health Clinic/Center
  • Lawson, MO
  • NPI 1356916555

  Member Of

  NPD member
• Excelsior Springs City Hospital

  dba Excelsior Springs Hospital Home Health/Hospice

  • Community Based Hospice Care Agency
  • Excelsior Springs, MO
  • NPI 1740380955

  Member Of

  NPD member
• Excelsior Springs Physician Clinic LLC

  • Clinic/Center
  • Lawson, MO
  • NPI 1851860498

  Member Of

  NPD member

Locations

All facility ownership & control disclosures 1

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

Owned or controlled facilities with NPI records 1

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

• Excelsior Springs City Hospital

  dba Lawson Primary Care

  • Rural Health Clinic/Center
  • Lawson, MO
  • NPI 1356916555

  5% Or Greater Direct Ownership Interest

  CMS ownership

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648771200000",
    "number": "1285637058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9150",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420029150",
            "telephone_number": "270-744-9600",
            "fax_number": "270-744-8642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 TRACY AVE.",
            "city": "EXCELSIOR SPRINGS",
            "state": "MO",
            "postal_code": "640241141",
            "telephone_number": "816-630-3000",
            "fax_number": "816-630-9530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF EXCELSIOR SPRINGS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A",
        "authorized_official_last_name": "ST JOHN",
        "authorized_official_first_name": "ZACHARY",
        "authorized_official_title_or_position": "ASST. CHIEF",
        "authorized_official_telephone_number": "816-630-3000"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "MO",
            "license": "047074",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800548307",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200266320A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excelsior Springs Fire Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert Jay Cantor, MD
• Caring Chiropractic
• Jodie Carpenter, NP-C
• Ashley Carter, DC
• Suthon Chatkupt, M.D.
• Jessica Maxine Clevenger, LMSW
• Stacia Conrick, PHARM.D.
• Olivia Marie Cook
• Christopher Cooper, MD
• Bethanne F Cordova, FNP

• Land Ambulance in Excelsior Springs, MO
• Providers in Excelsior Springs, MO by specialty
• Land Ambulance in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.