City of Mahtomedi

Primary specialty

AmbulanceTaxonomy code 341600000X

License

0268 Issued in MN

Legal business name

CITY OF MAHTOMEDI

Doing business as

Mahtomedi Fire Department

Practice address

800 Stillwater Rd
Mahtomedi, MN 55115

Phone

(651) 426-1080

Fax

(651) 426-1786

NPI assigned

Oct 11, 2006

Last updated

Aug 22, 2020By 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

Mr. Scott David Neilson

Title

City Administrator

Phone

(651) 426-3344

Specialties & licenses 1

Addresses

Other names 1

• Mahtomedi Fire Department Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295824126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 STILLWATER RD",
            "city": "MAHTOMEDI",
            "state": "MN",
            "postal_code": "551152007",
            "telephone_number": "651-426-3344",
            "fax_number": "651-426-1786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 STILLWATER RD",
            "city": "MAHTOMEDI",
            "state": "MN",
            "postal_code": "55115",
            "telephone_number": "651-426-1080",
            "fax_number": "651-426-1786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF MAHTOMEDI",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NEILSON",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CITY ADMINISTRATOR",
        "authorized_official_telephone_number": "651-426-3344",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "MN",
            "license": "0268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mahtomedi Fire Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael David Carlson, MSW, LICSW
• Kaci Ann Carroll, DPT
• Christina Marie Case, LMFT
• Lisa Kerstin Channon I
• Audrey Marie Chaput, OTR/L
• Richard Winfield Copeland Jr., DDS
• Core Chiropractic & Health
• Coventry Senior Living of Mahtomedi, LLC (Coventry Assisted Living and Memory Care)
• Jessica Dresden, PSYD, LP
• Amanda Lynn Engen

• Ambulance in Mahtomedi, MN
• Providers in Mahtomedi, MN by specialty
• Ambulance in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.