NPIMap

Organization Active NPI

Bsa Hospital, LLC

Doing business as BSA Health System EMS

  • Land Ambulance
  • Canyon, TX
National Provider Identifier
1417456583
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
1000883 Issued in TX
Legal business name
BSA HOSPITAL, LLC
Doing business as
BSA Health System EMS
Practice address
615 W Highway 60
Canyon, TX 79015-7302
Phone
(806) 336-8042
NPI assigned
Feb 5, 2018
Last updated
Jul 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Authorized official

Name
Stephen C. Petrovich
Title
Vice President
Phone
(615) 296-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 1000883 TX Primary

Addresses

Primary practice location

615 W Highway 60
Canyon, TX 79015-7302

Mailing address

615 W Highway 60
Canyon, TX 79015-7302
Phone (806) 655-7726

Other identifiers 1

IdentifierTypeStateIssuer
1000883OtherTXTEXAS DEPARTMENT OF STATE HEALTH SERVICES

Other names 1

  • BSA Health System EMS Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180323000121 TX Part B Supplier - Ambulance Service Supplier 6305090762 Practice locations: Amarillo, TX; Canyon, TX

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Bsa Hospital LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1000 S Coulter St
#A
Amarillo, TX 79106
Phone (806) 212-4700

1310 Wallace Blvd
#A
Amarillo, TX 79106
Phone (806) 356-1905

1500 Wallace Blvd
Amarillo, TX 79106
Phone (806) 354-5500

1500 Wallace Blvd
Ste 202
Amarillo, TX 79106
Phone (806) 212-0700

3501 S Soncy Rd
Ste 140A
Amarillo, TX 79119
Phone (806) 212-3464

721 N Taylor St
Amarillo, TX 79107
Phone (806) 212-7500

9010 S Georgia St
Amarillo, TX 79118
Phone (806) 655-7726

615 W Highway 60
Canyon, TX 79015
Phone (806) 336-8042

800 N Sumner St
Pampa, TX 79065
Phone (806) 665-6677

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Rehabilitation Hospital of AmarilloAmarillo, TX, CCN 743035 Hospital 5% Or Greater Direct Ownership Interest (49%) Aug 8, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1517788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752624000000",
    "number": "1417456583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 W HIGHWAY 60",
            "city": "CANYON",
            "state": "TX",
            "postal_code": "790157302",
            "telephone_number": "806-655-7726",
            "fax_number": "806-655-5529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 W HIGHWAY 60",
            "city": "CANYON",
            "state": "TX",
            "postal_code": "790157302",
            "telephone_number": "806-336-8042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BSA HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-05",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A",
        "authorized_official_last_name": "PETROVICH",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "615-296-3000"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "TX",
            "license": "1000883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS DEPARTMENT OF STATE HEALTH SERVICES",
            "identifier": "1000883",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BSA Health System EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canyon, TX

Sources for this page

Verify at the official NPI Registry.