City of Hazelwood

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

189235 Issued in MO

Legal business name

CITY OF HAZELWOOD

Practice address

6800 Howdershell Rd
Hazelwood, MO 63042-1214

Phone

(800) 538-8278

Fax

(580) 628-2273

NPI assigned

Oct 18, 2006

Organization subpart

No

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

Authorized official

Name

Jim Mathies

Title

Fire Chief

Phone

(800) 538-8278

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361836800000",
    "number": "1447331053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 HOWDERSHELL RD",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630421214",
            "telephone_number": "800-538-8278",
            "fax_number": "580-628-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 HOWDERSHELL RD",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630421214",
            "telephone_number": "800-538-8278",
            "fax_number": "580-628-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF HAZELWOOD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2013-02-26",
        "status": "A",
        "authorized_official_last_name": "MATHIES",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "800-538-8278"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MO",
            "license": "189235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806216206",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ESSENCE PROVIDER NUMBER",
            "identifier": "000000013441",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "198286",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Hazelwood, MO
• Providers in Hazelwood, MO by specialty
• Land Ambulance in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.