Organization Active NPI

Randolph County EMS

  • Ambulance
  • Winchester, IN
National Provider Identifier
1366434888
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
0272 Issued in IN
Legal business name
RANDOLPH COUNTY EMS
Practice address
110 E Hospital Dr
Winchester, IN 47394-2223
Phone
(765) 584-8055
Fax
(765) 584-1170
NPI assigned
Aug 19, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Authorized official

Name
Mr. Gary Moore
Title
Director
Phone
(317) 775-6753

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 0272 IN Primary

Addresses

Primary practice location

110 E Hospital Dr
Winchester, IN 47394-2223

Mailing address

PO Box 503024
Indianapolis, IN 46250-8024
Phone (317) 849-6628

Other identifiers 2

IdentifierTypeStateIssuer
300086525MedicaidIN
000000188952OtherINANTHEM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070510000263 IN Part B Supplier - Ambulance Service Supplier 3779689583 Practice locations: Winchester, IN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D0880324Randolph Co EMS110 Hospital Dr, Winchester, IN 47394Certificate of waiverDec 9, 2027

National Provider Directory

National Provider Directory

Locations

110 E Hospital Dr
Winchester, IN 47394
Phone (765) 584-8055

NPI Registry JSON

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785801600000",
    "number": "1366434888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 503024",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462508024",
            "telephone_number": "317-849-6628",
            "fax_number": "317-849-6632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E HOSPITAL DR",
            "city": "WINCHESTER",
            "state": "IN",
            "postal_code": "473942223",
            "telephone_number": "765-584-8055",
            "fax_number": "765-584-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDOLPH COUNTY EMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-19",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "317-775-6753",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "IN",
            "license": "0272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300086525",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000188952",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.