Active NPI
Central Emergency Medical Service, Inc.
- Ambulance
- Fayetteville, AR
National Provider Identifier
1396847166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulance
- License
- 146
- Legal business name
- CENTRAL EMERGENCY MEDICAL SERVICE, INC.
- Practice address
- 645 S School Ave
Fayetteville, AR 72701-6470 - Phone
- (479) 521-5801
- Fax
- (479) 521-1690
- NPI assigned
- Sep 2, 2006
- 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. Charles A Hickerson
- Title
- Chief Financial Officer
- Phone
- (479) 521-5801
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | 146 | AR | Primary |
Addresses
Primary practice location
645 S School Ave
Fayetteville, AR 72701-6470
Mailing address
645 S School Ave
Fayetteville, AR 72701-6470
Phone (479) 521-5801
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 807826102 | Medicaid | MO | |
| 100817780A | Medicaid | OK | |
| 106403715 | Medicaid | AR |
Other names 1
- CENTRAL EMS
National Provider Directory
National Provider DirectoryLocations
645 S School Ave
Fayetteville, AR 72701
Phone (479) 521-5801
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157155200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1279843200000",
"number": "1396847166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "645 S SCHOOL AVE",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727016470",
"telephone_number": "479-521-5801",
"fax_number": "479-521-1690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "645 S SCHOOL AVE",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727016470",
"telephone_number": "479-521-5801",
"fax_number": "479-521-1690"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CENTRAL EMERGENCY MEDICAL SERVICE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-02",
"last_updated": "2010-07-23",
"status": "A",
"authorized_official_last_name": "HICKERSON",
"authorized_official_first_name": "CHARLES",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "479-521-5801",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "341600000X",
"taxonomy_group": "",
"desc": "Ambulance",
"state": "AR",
"license": "146",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "807826102",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100817780A",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "106403715",
"state": "AR"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CENTRAL EMS",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.