City of Mountain Brook

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

0318 Issued in AL

Legal business name

CITY OF MOUNTAIN BROOK

Doing business as

City of Mountain Brook Fire Department

Practice address

100 Hoyt LN
Birmingham, AL 35213-3710

Phone

(205) 802-3838

Fax

(205) 879-5919

NPI assigned

Oct 2, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Robert W Ezekiel, PARAMEDIC

Title

Chief

Phone

(205) 802-3838

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• City of Mountain Brook Fire Department Doing business as

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276128000000",
    "number": "1427141126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130597",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352130597",
            "telephone_number": "205-956-1172",
            "fax_number": "205-384-9758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOYT LN",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352133710",
            "telephone_number": "205-802-3838",
            "fax_number": "205-879-5919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF MOUNTAIN BROOK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2010-06-10",
        "status": "A",
        "authorized_official_last_name": "EZEKIEL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "205-802-3838",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PARAMEDIC"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "AL",
            "license": "0318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE SOUTH",
            "identifier": "1427141126",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200037116",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "510-26069",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "City of Mountain Brook Fire Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Cheryl A Clabough, CRNA
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• David William Clanton, D.M.D.

• Land Ambulance in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Land Ambulance in Alabama

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