North Miss Ambulance Service Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

067 Issued in MS

Legal business name

NORTH MISS AMBULANCE SERVICE INC

Practice address

2202 E Chambers Drive
Booneville, MS 38829

Phone

(662) 728-3201

Fax

(662) 728-1403

NPI assigned

Sep 11, 2006

Last updated

Apr 5, 2017By 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

Mr. Timothy Dorn

Title

Cfo

Phone

(303) 495-1200

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491350400000",
    "number": "1396849436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198408",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848408",
            "telephone_number": "330-762-8891",
            "fax_number": "330-384-4019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 E CHAMBERS DRIVE",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "38829",
            "telephone_number": "662-728-3201",
            "fax_number": "662-728-1403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH MISS AMBULANCE SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-11",
        "last_updated": "2017-04-05",
        "status": "A",
        "authorized_official_last_name": "DORN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "303-495-1200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MS",
            "license": "067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00050885",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1517593",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• MSK Group, PC
• Amanda Mullins
• Kathryn Gann Murff, MS
• Nathan W Baldwin MD PA
• Carol Sue Nichols, MA
• North Mississippi Medical Center
• North Mississippi Medical Clinics Inc (Booneville Medical Clinic and Urgent Care)
• North Mississippi Primary Health Care, Inc.
• North Mississippi Pulmonology Clinic Inc
• Northeast Mississippi Community Services, Inc..

• Land Ambulance in Booneville, MS
• Providers in Booneville, MS by specialty
• Land Ambulance in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.