County of Grant

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

61206 Issued in WV

Legal business name

COUNTY OF GRANT

Practice address

117 Virginia Ave
Petersburg, WV 26847-1713

Phone

(681) 592-0246

Fax

(681) 892-0248

NPI assigned

Sep 18, 2017

Organization subpart

No

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

Authorized official

Name

Jeremy Hottinger

Title

EMS Director

Phone

(681) 892-0246

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• GRANT COUNTY AMBULANCE Doing business as

Medicare fee-for-service enrollment

Enrolled in WV

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

Member organizations 5

Organizations listed as members of this organization in the National Provider Directory.

• Grant Memorial Hospital

  • Multi-Specialty Clinic/Center
  • Petersburg, WV
  • NPI 1396744108

  Member Of

  NPD member
• Grant Memorial Hospital

  • Orthopaedic Surgery Physician
  • Petersburg, WV
  • NPI 1407248800

  Member Of

  NPD member
• Grant Memorial Hospital

  • Critical Access Hospital
  • Petersburg, WV
  • NPI 1598763666

  Member Of

  NPD member
• Grant Memorial Hospital

  • Skilled Nursing Facility
  • Petersburg, WV
  • NPI 1811936032

  Member Of

  NPD member
• Grant Memorial Hospital

  • Specialist
  • Petersburg, WV
  • NPI 1972983393

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713744000000",
    "number": "1407375827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 4TH AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257011407",
            "telephone_number": "304-521-1576",
            "fax_number": "304-521-1576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 VIRGINIA AVE",
            "city": "PETERSBURG",
            "state": "WV",
            "postal_code": "268471713",
            "telephone_number": "681-592-0246",
            "fax_number": "681-892-0248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF GRANT",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-18",
        "last_updated": "2024-04-22",
        "status": "A",
        "authorized_official_last_name": "HOTTINGER",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "EMS DIRECTOR",
        "authorized_official_telephone_number": "681-892-0246"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WV",
            "license": "61206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "003710143",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRANT COUNTY AMBULANCE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William Cook
• Melissa Copper
• Brittany Corbin
• Misty Corbin, FNP
• Angela Cosner, RN
• Tori Crider
• Cristina L. Goldizen
• Bailey Crites
• Carolyn Kay Crites
• Sherri Lynn Crites

• Land Ambulance in Petersburg, WV
• Providers in Petersburg, WV by specialty
• Land Ambulance in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.