Organization Active NPI

West Hancock County Ambulance Serv Inc

  • Land Ambulance
  • Britt, IA
National Provider Identifier
1417982018
Registry record updated Feb 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
WEST HANCOCK COUNTY AMBULANCE SERV INC
Practice address
20 1 Avenue SW
Britt, IA 50423
Phone
(641) 843-3750
Fax
(641) 843-3888
NPI assigned
Jul 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2013

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

Authorized official

Name
Jennifer Bourg
Title
Paramedic
Phone
(641) 843-3750

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

20 1 Avenue SW
Britt, IA 50423

Mailing address

PO Box 347
Britt, IA 50423-0347
Phone (641) 843-3750

Other identifiers 1

IdentifierTypeStateIssuer
0125211MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070905000567 IA Part B Supplier - Ambulance Service Supplier 7517050685 Practice locations: Britt, IA

National Provider Directory

National Provider Directory

Locations

20 1st Ave SW
Britt, IA 50423
Phone (641) 843-3750

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359936000000",
    "number": "1417982018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 347",
            "city": "BRITT",
            "state": "IA",
            "postal_code": "504230347",
            "telephone_number": "641-843-3750",
            "fax_number": "641-843-3888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 1 AVENUE SW",
            "city": "BRITT",
            "state": "IA",
            "postal_code": "50423",
            "telephone_number": "641-843-3750",
            "fax_number": "641-843-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST HANCOCK COUNTY AMBULANCE SERV INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2013-02-04",
        "status": "A",
        "authorized_official_last_name": "BOURG",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PARAMEDIC",
        "authorized_official_telephone_number": "641-843-3750"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0125211",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Britt, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2013; 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.