NPIMap

Organization Active NPI

Scott County

  • Land Ambulance
  • Scottsburg, IN
National Provider Identifier
1457459737
Registry record updated Apr 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
0898 Issued in IN
Legal business name
SCOTT COUNTY
Practice address
1468 Scott Valley Dr
Scottsburg, IN 47170-7795
Phone
(812) 754-0500
Fax
(812) 754-0501
NPI assigned
Sep 20, 2006
Last updated
Apr 21, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2017

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

Authorized official

Name
Jacob Carroll
Title
EMS Director
Phone
(812) 754-0500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 0898 IN Primary

Addresses

Primary practice location

1468 Scott Valley Dr
Scottsburg, IN 47170-7795

Mailing address

PO Box 727
Elkhart, IN 46515-0727
Phone (574) 293-3030

Other identifiers 3

IdentifierTypeStateIssuer
000000363633OtherINANTHEM
200513620AMedicaidIN
P00345462OtherRRMC PTAN

Other names 1

  • Scott County EMS Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050518000729 IN Part B Supplier - Ambulance Service Supplier 4789625906 Practice locations: Scottsburg, IN

National Provider Directory

National Provider Directory
Tax ID family
Scott Co Health Deptchildren's Health Clinic3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

1468 Scott Valley Dr
Scottsburg, IN 47170
Phone (812) 754-0500

87 E Wardell St
Scottsburg, IN 47170
Phone (812) 752-8484

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492732800000",
    "number": "1457459737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 727",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465150727",
            "telephone_number": "574-293-3030",
            "fax_number": "574-294-1345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1468 SCOTT VALLEY DR",
            "city": "SCOTTSBURG",
            "state": "IN",
            "postal_code": "471707795",
            "telephone_number": "812-754-0500",
            "fax_number": "812-754-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2017-04-21",
        "status": "A",
        "authorized_official_last_name": "CARROLL",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "EMS DIRECTOR",
        "authorized_official_telephone_number": "812-754-0500"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IN",
            "license": "0898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000363633",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200513620A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC PTAN",
            "identifier": "P00345462",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Scott County EMS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Scottsburg, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2017; 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.