Active NPI
Randolph County EMS
- Ambulance
- Winchester, IN
National Provider Identifier
1366434888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulance
- License
- 0272
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300086525 | Medicaid | IN | |
| 000000188952 | Other | IN | ANTHEM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070510000263 | IN | Part B Supplier - Ambulance Service Supplier | 3779689583 | Practice locations: Winchester, IN |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 15D0880324 | Randolph Co EMS | Certificate of waiver | Dec 9, 2027 |
National Provider Directory
National Provider DirectoryLocations
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.