Active NPI
Westmoreland County
- Ambulance
- Montross, VA
National Provider Identifier
1407039126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulance
- License
- 1274
- Legal business name
- WESTMORELAND COUNTY
- Practice address
- 111 Polk Street
Montross, VA 22520 - Phone
- (804) 493-0130
- NPI assigned
- Dec 17, 2007
- Last updated
- Dec 17, 2007
- 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
- Calvin Balderson Jr.
- Title
- Deputy EMS Coordinator
- Phone
- (804) 493-0130
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | 1274 | VA | Primary |
Addresses
Primary practice location
111 Polk Street
Montross, VA 22520
Mailing address
PO Box 1000
Montross, VA 22520-1000
Phone (804) 493-0130
Other names 1
- Westmoreland County Dept of EMS
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080229000430 | VA | Part B Supplier - Ambulance Service Supplier | 5395829204 | Practice locations: Montross, VA |
National Provider Directory
National Provider DirectoryLocations
111 Polk St
Montross, VA 22520
Phone (804) 493-0130
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197849600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1197849600000",
"number": "1407039126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1000",
"city": "MONTROSS",
"state": "VA",
"postal_code": "225201000",
"telephone_number": "804-493-0130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 POLK STREET",
"city": "MONTROSS",
"state": "VA",
"postal_code": "22520",
"telephone_number": "804-493-0130"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WESTMORELAND COUNTY",
"organizational_subpart": "NO",
"enumeration_date": "2007-12-17",
"last_updated": "2007-12-17",
"status": "A",
"authorized_official_last_name": "BALDERSON",
"authorized_official_first_name": "CALVIN",
"authorized_official_title_or_position": "DEPUTY EMS COORDINATOR",
"authorized_official_telephone_number": "804-493-0130",
"authorized_official_name_suffix": "Jr."
},
"taxonomies": [
{
"code": "341600000X",
"taxonomy_group": "",
"desc": "Ambulance",
"state": "VA",
"license": "1274",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Westmoreland County Dept of EMS",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Montross, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; 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.