NPIMap

Organization Active NPI

City of Sauk Centre

  • Land Ambulance
  • Sauk Centre, MN
National Provider Identifier
1285665794
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
CITY OF SAUK CENTRE
Practice address
320 South Oak Street
Sauk Centre, MN 56378
Phone
(651) 653-2201
Fax
(651) 653-2213
NPI assigned
Jul 5, 2006
Last updated
Apr 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

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

Authorized official

Name
Mrs. Diane L Tallackson
Title
Billing Manger
Phone
(651) 653-2201

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

320 South Oak Street
Sauk Centre, MN 56378

Mailing address

320 South Oak Street
Sauk Centre, MN 56378
Phone (651) 653-2201

Other identifiers 3

IdentifierTypeStateIssuer
55335SAOtherMNBLUE CROSS BLUE SHIELD
590012896OtherMNRAILROAD MEDICARE
774867100MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080611000746 MN Part B Supplier - Ambulance Service Supplier 2860437407 Practice locations: Sauk Centre, MN

National Provider Directory

National Provider Directory

Member organizations 5

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

Locations

1300 Timberlane Dr
Sauk Centre, MN 56378
Phone (320) 352-2203

320 Oak St S
Sauk Centre, MN 56378
Phone (320) 352-2203

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1285665794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 SOUTH OAK STREET",
            "city": "SAUK CENTRE",
            "state": "MN",
            "postal_code": "56378",
            "telephone_number": "651-653-2201",
            "fax_number": "651-653-2213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 SOUTH OAK STREET",
            "city": "SAUK CENTRE",
            "state": "MN",
            "postal_code": "56378",
            "telephone_number": "651-653-2201",
            "fax_number": "651-653-2213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF SAUK CENTRE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "TALLACKSON",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BILLING MANGER",
        "authorized_official_telephone_number": "651-653-2201",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "55335SA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590012896",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "774867100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sauk Centre, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.