NPIMap

Organization Active NPI

Southeast Colorado Hospital District Ambulance

  • Ambulance
  • Springfield, CO
National Provider Identifier
1316167489
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
Legal business name
SOUTHEAST COLORADO HOSPITAL DISTRICT AMBULANCE
Practice address
972 Kansas St
Springfield, CO 81073-1643
Phone
(719) 523-4501
Fax
(719) 523-4290
NPI assigned
Apr 30, 2007
Last updated
Apr 29, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHEAST COLORADO HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Authorized official

Name
Carla Forrest
Title
Him Director
Phone
(719) 523-2125

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X Primary

Addresses

Primary practice location

972 Kansas St
Springfield, CO 81073-1643

Mailing address

373 E 10TH Ave
Springfield, CO 81073-1622
Phone (719) 523-4501

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040310001440 CO Part B Supplier - Clinic/Group Practice 6204725138 Receives reassigned benefits from 13 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Springfield, CO

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Southeast Co Hosptial

Locations

200 E 10th Ave
Springfield, CO 81073
Phone (719) 523-4501

204 E 10th Ave
Springfield, CO 81073
Phone (719) 523-4501

324 E 9th Ave
Springfield, CO 81073
Phone (719) 523-2194

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1177891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714348800000",
    "number": "1316167489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "373 E 10TH AVE",
            "city": "SPRINGFIELD",
            "state": "CO",
            "postal_code": "810731622",
            "telephone_number": "719-523-4501",
            "fax_number": "719-523-4290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "972 KANSAS ST",
            "city": "SPRINGFIELD",
            "state": "CO",
            "postal_code": "810731643",
            "telephone_number": "719-523-4501",
            "fax_number": "719-523-4290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST COLORADO HOSPITAL DISTRICT AMBULANCE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHEAST COLORADO HOSPITAL DISTRICT",
        "enumeration_date": "2007-04-30",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A",
        "authorized_official_last_name": "FORREST",
        "authorized_official_first_name": "CARLA",
        "authorized_official_title_or_position": "HIM DIRECTOR",
        "authorized_official_telephone_number": "719-523-2125"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; 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.