County of Johnson

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

55018 Issued in IL

Legal business name

COUNTY OF JOHNSON

Doing business as

Johnson County Ambulance Service

Practice address

155 Industrial Drive
Vienna, IL 62995-0038

Phone

(618) 658-2131

Fax

(618) 658-8134

NPI assigned

Mar 1, 2007

Last updated

May 10, 2010By 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

Ms. Wendi Bailey

Title

Director

Phone

(618) 658-2131

Specialties & licenses 1

Addresses

Other names 1

• Johnson County Ambulance Service Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273449600000",
    "number": "1407984297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 INDUSTRIAL DRIVE",
            "address_2": "P.O. BOX 38",
            "city": "VIENNA",
            "state": "IL",
            "postal_code": "629950038",
            "telephone_number": "618-658-2131",
            "fax_number": "618-658-8134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 INDUSTRIAL DRIVE",
            "city": "VIENNA",
            "state": "IL",
            "postal_code": "629950038",
            "telephone_number": "618-658-2131",
            "fax_number": "618-658-8134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF JOHNSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2010-05-10",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "WENDI",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "618-658-2131",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "55018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Johnson County Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brandi Campbell, BA, MHP
• John Cantrell, BA, MHP
• Lexi Clark, BS MHP
• Fallon Clayton I
• Timothy Michael Corzine, LCSW
• Sherrie Leann Crabb, MS, QMHP
• Sharon Craig, BSE, MHP
• Martha Jane Crawford, LCSW
• Mary Elizabeth Daubert
• Alfonso Chy David, M.D.

• Land Ambulance in Vienna, IL
• Providers in Vienna, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2010; 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.

Verify at the official NPI Registry.