NPIMap

Organization Active NPI

Lifeguard Ambulance Service LLC

  • Land Ambulance
  • Weatherford, OK
National Provider Identifier
1386188829
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
LIFEGUARD AMBULANCE SERVICE LLC
Practice address
118 N Kansas St
Weatherford, OK 73096-5442
Phone
(580) 772-7971
NPI assigned
Dec 16, 2016
Last updated
Sep 15, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
LIFEGUARD AMBULANCE SERVICE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Authorized official

Name
Timothy Joseph Dorn
Title
Chief Administrative Officer
Phone
(833) 703-2294

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

118 N Kansas St
Weatherford, OK 73096-5442

Mailing address

PO Box 847925
Dallas, TX 75284-7925
Phone (800) 913-9106

Other identifiers 2

IdentifierTypeStateIssuer
200659960DMedicaidOK
200659960BMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170121000125 OK Part B Supplier - Ambulance Service Supplier 0143453142 1 other NPI on this enrollment
Practice locations: Binger, OK; Weatherford, OK

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Lifeguard Ambulance Service LLC10 organizations share this tax ID, including this one
Part of
Lifeguard Ambulance Service LLC

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1481846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757894400000",
    "number": "1386188829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 847925",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847925",
            "telephone_number": "800-913-9106",
            "fax_number": "330-384-4019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 N KANSAS ST",
            "city": "WEATHERFORD",
            "state": "OK",
            "postal_code": "730965442",
            "telephone_number": "580-772-7971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEGUARD AMBULANCE SERVICE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFEGUARD AMBULANCE SERVICE LLC",
        "enumeration_date": "2016-12-16",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A",
        "authorized_official_last_name": "DORN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "833-703-2294"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200659960D",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200659960B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weatherford, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.