Organization Active NPI

County of Stanton

  • Ambulance
  • Johnson, KS
National Provider Identifier
1295792869
Registry record updated Jan 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
1860 Issued in KS
Legal business name
COUNTY OF STANTON
Practice address
101 S Frontage Road
Johnson, KS 67855-0572
Phone
(620) 492-6879
Fax
(620) 492-1445
NPI assigned
Apr 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2020

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

Authorized official

Name
Roger L Richardson
Title
Director
Phone
(620) 492-6879

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 1860 KS Primary

Addresses

Primary practice location

101 S Frontage Road
Johnson, KS 67855-0572

Mailing address

Box 572
101 S. Frontage Road
Johnson, KS 67855-0572
Phone (620) 492-6879

Other identifiers 3

IdentifierTypeStateIssuer
100097820BKSMedicaidKS
112009OtherKSBLUE CROSS
100097820BMedicaidKS

Other names 1

  • Stanton County Ambulance Service Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120228000414 KS Part B Supplier - Ambulance Service Supplier 3577699602 Practice locations: Johnson, KS

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D0980592Stanton County EMS101 S Frontage Rd, Johnson, KS 67855Certificate of waiverNov 27, 2026

National Provider Directory

National Provider Directory
Tax ID family
Stanton County Family P2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Stanton County Family PracticeJohnson, KS, CCN 178572 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1966

Owned or controlled facilities with NPI records 1

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

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578009600000",
    "number": "1295792869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 572",
            "address_2": "101 S. FRONTAGE ROAD",
            "city": "JOHNSON",
            "state": "KS",
            "postal_code": "678550572",
            "telephone_number": "620-492-6879",
            "fax_number": "620-492-1445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S FRONTAGE ROAD",
            "city": "JOHNSON",
            "state": "KS",
            "postal_code": "678550572",
            "telephone_number": "620-492-6879",
            "fax_number": "620-492-1445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF STANTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-27",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "620-492-6879"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "KS",
            "license": "1860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100097820BKS",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "112009",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100097820B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stanton County Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Stanton County Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Johnson, KS

Sources for this page

Verify at the official NPI Registry.