Physician Ambulance Services LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1225 Issued in IN

Legal business name

PHYSICIAN AMBULANCE SERVICES LLC

Practice address

2667 Rand Rd
Indianapolis, IN 46241-5501

Phone

(317) 813-9595

Fax

(502) 531-0103

NPI assigned

May 24, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Joshua M Keywood

Title

President Managing Partner

Phone

(317) 813-9595

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621382400000",
    "number": "1346697901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2667 RAND RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462415501",
            "telephone_number": "317-746-6440",
            "fax_number": "502-531-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2667 RAND RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462415501",
            "telephone_number": "317-813-9595",
            "fax_number": "502-531-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN AMBULANCE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-24",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A",
        "authorized_official_last_name": "KEYWOOD",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT MANAGING PARTNER",
        "authorized_official_telephone_number": "317-813-9595",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IN",
            "license": "1225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201380960A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; 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.