NPIMap

Organization Active NPI

Village of Harrison

Doing business as Sioux County Rescue Unit

  • Land Ambulance
  • Harrison, NE
National Provider Identifier
1336227701
Registry record updated Jun 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
1268 Issued in NE
Legal business name
VILLAGE OF HARRISON
Doing business as
Sioux County Rescue Unit
Practice address
479 Main St
Harrison, NE 69346
Phone
(402) 572-4019
Fax
(402) 965-8594
NPI assigned
Nov 1, 2006
Last updated
Jun 30, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2010

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

Authorized official

Name
Misty Skavdahl
Title
EMS Director
Phone
(402) 572-4019

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 1268 NE Primary

Addresses

Primary practice location

479 Main St
Harrison, NE 69346

Mailing address

PO Box 641880
Omaha, NE 68164-7880
Phone (402) 572-4019

Other identifiers 2

IdentifierTypeStateIssuer
39498OtherNEBLUE CROSS PROVIDER NO
P00123229OtherNERR MEDICARE PROVIDER NO

Other names 1

  • SIOUX COUNTY RESCUE UNIT Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040119000706 NE Part B Supplier - Ambulance Service Supplier 7719888080 Practice locations: Harrison, NE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277856000000",
    "number": "1336227701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 641880",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681647880",
            "telephone_number": "402-572-4019",
            "fax_number": "402-965-8594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "479 MAIN ST",
            "city": "HARRISON",
            "state": "NE",
            "postal_code": "69346",
            "telephone_number": "402-572-4019",
            "fax_number": "402-965-8594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF HARRISON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2010-06-30",
        "status": "A",
        "authorized_official_last_name": "SKAVDAHL",
        "authorized_official_first_name": "MISTY",
        "authorized_official_title_or_position": "EMS DIRECTOR",
        "authorized_official_telephone_number": "402-572-4019"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NE",
            "license": "1268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NO",
            "identifier": "39498",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PROVIDER NO",
            "identifier": "P00123229",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SIOUX COUNTY RESCUE UNIT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harrison, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2010; 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.