Active NPI
Blythe Ambulance Service
- Land Ambulance
- Blythe, CA
National Provider Identifier
1407864341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- A125
- Legal business name
- BLYTHE AMBULANCE SERVICE
- Practice address
- 129 S 1St St
Blythe, CA 92225-2518 - Phone
- (760) 922-8460
- Fax
- (760) 883-5011
- NPI assigned
- Aug 4, 2006
- Last updated
- Sep 15, 2025
- 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
- Timothy Joseph Dorn
- Title
- Chief Administrative Officer
- Phone
- (833) 703-2294
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | NU | ||
| Land Ambulance | 3416L0300X | A125 | CA | Primary |
Addresses
Primary practice location
129 S 1St St
Blythe, CA 92225-2518
Mailing address
PO Box 55418
Los Angeles, CA 90074-5418
Phone (800) 913-9106
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 070384 | Medicaid | AZ | |
| 1407864341 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110428000597 | CA | Part B Supplier - Ambulance Service Supplier | 4284819673 | Practice locations: Blythe, CA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2099465 | Blythe Ambulance Service | Certificate of waiver | Jul 27, 2027 |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba American Medical Response (AMR)
- Ambulance
- Palm Springs, CA
- NPI 1689608994
Member Of
Locations
129 S 1st St
Blythe, CA 92225
Phone (619) 922-8460
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154649600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757894400000",
"number": "1407864341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 55418",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900745418",
"telephone_number": "800-913-9106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "129 S 1ST ST",
"city": "BLYTHE",
"state": "CA",
"postal_code": "922252518",
"telephone_number": "760-922-8460",
"fax_number": "760-883-5011"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BLYTHE AMBULANCE SERVICE",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-04",
"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": "NU",
"license": null,
"primary": false
},
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "CA",
"license": "A125",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "070384",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1407864341",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Blythe, CA
- Barnet Dulaney Perkins Eye Center, PC (Blythe Vision Care)
- Timothy Lawrence Barrett, CCAPP R1289870218
- Rogelio Miguel Batson Jr.
- Bio-Medical Applications of California, Inc. (Bma Blythe Desert Dialysis)
- Kaitlyn Juliana Birdsong
- Blythe Eye Care Medical Group
- Blythe Healthcare Services, Inc.
- Blythe Internal Medicine Clinic Inc
- Blythe Oasis Community Inc
- Blythe Post Acute LLC
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.
- 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.