Midwest Medical Rides, LLC

Key facts

NPI

1295518918

Entity type

Organization (NPI type 2)

Primary specialty

Non-emergency Medical Transport (VAN) 343900000X

Legal business name

MIDWEST MEDICAL RIDES, LLC

Practice address

1253 N 25TH St
Fort Dodge, IA 50501-2110

Phone

(515) 302-4761

NPI assigned

Aug 16, 2023

Organization subpart

No

Authorized official

Name

Keely Grell

Title

Office Manager

Phone

(515) 302-4761

National Provider Directory

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 16, 2023.

{
    "created_epoch": "1692144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692144000000",
    "number": "1295518918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 1ST AVE N STE 9",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505013804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1253 N 25TH ST",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505012110",
            "telephone_number": "515-302-4761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST MEDICAL RIDES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-16",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A",
        "authorized_official_last_name": "GRELL",
        "authorized_official_first_name": "KEELY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "515-302-4761"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0124753",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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