Organization Active NPI

Lamoille Ambulance Service,Inc.

  • Ambulance
  • Johnson, VT
National Provider Identifier
1437188398
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
Legal business name
LAMOILLE AMBULANCE SERVICE,INC.
Practice address
93 Lower Main West
Johnson, VT 05656-0352
Phone
(802) 635-7724
Fax
(802) 635-2050
NPI assigned
Jul 2, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kerri Ohalloran
Title
Compliance Officer
Phone
(802) 635-7724

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X Primary

Addresses

Primary practice location

93 Lower Main West
Johnson, VT 05656-0352

Mailing address

PO Box 352
Johnson, VT 05656-0352
Phone (802) 635-7724

Other identifiers 2

IdentifierTypeStateIssuer
01347442MedicaidNY
0006452MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, VT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060509000418 NY Part B Supplier - Ambulance Service Supplier 0345251005 Practice locations: Ticonderoga, NY
O20070718000069 VT Part B Supplier - Ambulance Service Supplier 0345251005 Practice locations: Johnson, VT; Williston, VT

National Provider Directory

National Provider Directory

Locations

454 Shunpike Rd
Williston, VT 05495
Phone (802) 860-1532

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437188398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 352",
            "city": "JOHNSON",
            "state": "VT",
            "postal_code": "056560352",
            "telephone_number": "802-635-7724",
            "fax_number": "802-635-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 LOWER MAIN WEST",
            "city": "JOHNSON",
            "state": "VT",
            "postal_code": "056560352",
            "telephone_number": "802-635-7724",
            "fax_number": "802-635-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAMOILLE AMBULANCE SERVICE,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OHALLORAN",
        "authorized_official_first_name": "KERRI",
        "authorized_official_title_or_position": "COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "802-635-7724"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01347442",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006452",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.