Northern Greenbrier Ambulance Service Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

NORTHERN GREENBRIER AMBULANCE SERVICE INC

Practice address

Route 219 Box 74
Renick, WV 24966-0000

Phone

(304) 497-4334

NPI assigned

Jul 14, 2005

Last updated

Oct 19, 2012By 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

Chris Boggs

Title

Chief

Phone

(304) 497-4334

Specialties & licenses 1

Addresses

Other identifiers 8

Locations

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350604800000",
    "number": "1346249117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 4TH AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257010000",
            "telephone_number": "304-521-1576",
            "fax_number": "304-521-1768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ROUTE 219 BOX 74",
            "city": "RENICK",
            "state": "WV",
            "postal_code": "249660000",
            "telephone_number": "304-497-4334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN GREENBRIER AMBULANCE SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-14",
        "last_updated": "2012-10-19",
        "status": "A",
        "authorized_official_last_name": "BOGGS",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "304-497-4334"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "590011733",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0145418000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "080247600",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "55080796",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "001705371",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OH WORKERS COMP",
            "identifier": "5508079600",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV WORKERS COMP",
            "identifier": "5508079600",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARELINK",
            "identifier": "224444",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bonnie Dupper Gifford, M.D.
• Ashley Harrison
• Summer Harrison, ATC
• Lydia Lewis
• Vicky McCoy
• Jessica Ann Sims

• Land Ambulance in Renick, WV
• Providers in Renick, WV by specialty
• Land Ambulance in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.