City of Evansdale

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

2070400 Issued in IA

Legal business name

CITY OF EVANSDALE

Doing business as

Evansdale Fire and Rescue

Practice address

911 S Evans Rd
Evansdale, IA 50707-1647

Phone

(319) 233-6930

Fax

(319) 274-8966

NPI assigned

Nov 30, 2006

Last updated

Feb 16, 2023By 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

Kent Smock

Title

Ambulance Director

Phone

(319) 233-6930

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• EVANSDALE FIRE AND RESCUE Doing business as

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676505600000",
    "number": "1376610576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 N EVANS RD",
            "city": "EVANSDALE",
            "state": "IA",
            "postal_code": "507071115",
            "telephone_number": "319-232-6683",
            "fax_number": "319-232-1586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 S EVANS RD",
            "city": "EVANSDALE",
            "state": "IA",
            "postal_code": "507071647",
            "telephone_number": "319-233-6930",
            "fax_number": "319-274-8966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF EVANSDALE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A",
        "authorized_official_last_name": "SMOCK",
        "authorized_official_first_name": "KENT",
        "authorized_official_title_or_position": "AMBULANCE DIRECTOR",
        "authorized_official_telephone_number": "319-233-6930"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IA",
            "license": "2070400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0093773",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "09377",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EVANSDALE FIRE AND RESCUE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Angela Kay Ames, ARNP
• Blackhawk Pharmacy (Evans Crossing Pharmacy)
• Kyle Borrett, DC
• Covenant Medical Center, Inc. (MercyOne Evansdale home medical equipment)
• Doris Dilparic
• Megan Marie Drew, PA-C
• Evansdale Chiropractic Clinic, PLC
• Evansdale Pharmacy, Inc.

• Land Ambulance in Evansdale, IA
• Providers in Evansdale, IA by specialty
• Land Ambulance in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; 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.