City of Santa Rosa

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

PRC13478 Issued in NM

Legal business name

CITY OF SANTA ROSA

Practice address

141 S 5TH St
Santa Rosa, NM 88435-2369

Phone

(505) 472-3404

NPI assigned

Aug 25, 2005

Last updated

Nov 3, 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

Mr. Kevin Ortiz

Title

EMS Clerk

Phone

(575) 472-0367

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Santa Rosa Ambulance Other name

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Locations

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667433600000",
    "number": "1306839253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18230",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152360230",
            "telephone_number": "505-472-3404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 S 5TH ST",
            "city": "SANTA ROSA",
            "state": "NM",
            "postal_code": "884352369",
            "telephone_number": "505-472-3404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF SANTA ROSA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-25",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A",
        "authorized_official_last_name": "ORTIZ",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "EMS CLERK",
        "authorized_official_telephone_number": "575-472-0367",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NM",
            "license": "PRC13478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "R0852",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Santa Rosa Ambulance",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Santa Rosa Ambulance",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Land Ambulance in Santa Rosa, NM
• Providers in Santa Rosa, NM by specialty
• Land Ambulance in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; 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.