Organization Active NPI

Medic One, LLC

Doing business as Medic One Ambulance Service

  • Land Ambulance
  • Jonesboro, AR
National Provider Identifier
1336114131
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
627 Issued in AR
Legal business name
MEDIC ONE, LLC
Doing business as
Medic One Ambulance Service
Practice address
6007 Dalton Farmer Dr
Jonesboro, AR 72404-8895
Phone
(870) 972-0708
Fax
(870) 972-5787
NPI assigned
Feb 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Authorized official

Name
William Rosenberg
Title
Ceo
Phone
(410) 753-1831

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 626 AR
Land Ambulance 3416L0300X 627 AR Primary
Land Ambulance 3416L0300X 629 AR

Addresses

Primary practice location

6007 Dalton Farmer Dr
Jonesboro, AR 72404-8895

Mailing address

6007 Dalton Farmer Dr
Jonesboro, AR 72404-8895
Phone (870) 972-0708

Other identifiers 2

IdentifierTypeStateIssuer
808958300MedicaidMO
142297715MedicaidAR

Other names 1

  • MEDIC ONE AMBULANCE SERVICE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051213000883 AR Part B Supplier - Ambulance Service Supplier 3779511852 Practice locations: Lake City, AR; Walnut Ridge, AR; Trumann, AR; Jonesboro, AR; Harrisburg, AR

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Medic One LLC2 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.

Locations

3301 S Caraway Rd
Jonesboro, AR 72404
Phone (870) 972-8484

5504 E Johnson Ave
Jonesboro, AR 72405
Phone (501) 932-3271

6007 Dalton Farmer Dr
Jonesboro, AR 72404
Phone (870) 972-8484

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778544000000",
    "number": "1336114131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6007 DALTON FARMER DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724048895",
            "telephone_number": "870-972-0708",
            "fax_number": "870-972-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6007 DALTON FARMER DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724048895",
            "telephone_number": "870-972-0708",
            "fax_number": "870-972-5787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIC ONE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-23",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A",
        "authorized_official_last_name": "ROSENBERG",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-753-1831"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "AR",
            "license": "626",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "AR",
            "license": "627",
            "primary": true
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "AR",
            "license": "629",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "808958300",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142297715",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDIC ONE AMBULANCE SERVICE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MEDIC ONE AMBULANCE SERVICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; 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.