City of Montgomery

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

0165 Issued in MN

Legal business name

CITY OF MONTGOMERY

Doing business as

Montgomery General Ambulance

Practice address

201 Ash Ave SW
Montgomery, MN 56069-1225

Phone

(507) 364-8888

NPI assigned

Dec 11, 2006

Last updated

Dec 12, 2023By 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

Brian Heck

Title

City Administator / Ao

Phone

(507) 364-8888

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Montgomery General Ambulance 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": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702339200000",
    "number": "1326108150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 ASH AVE SW",
            "city": "MONTGOMERY",
            "state": "MN",
            "postal_code": "560691225",
            "telephone_number": "507-364-8888",
            "fax_number": "507-953-2071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 ASH AVE SW",
            "city": "MONTGOMERY",
            "state": "MN",
            "postal_code": "560691225",
            "telephone_number": "507-364-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF MONTGOMERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A",
        "authorized_official_last_name": "HECK",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CITY ADMINISTATOR / AO",
        "authorized_official_telephone_number": "507-364-8888"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MN",
            "license": "0165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "452367900",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "45074CI",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Montgomery General Ambulance",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Montgomery General Ambulance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Land Ambulance in Montgomery, MN
• Providers in Montgomery, MN by specialty
• Land Ambulance in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; 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.