Organization Active NPI

Life Emergency Medical Service, Inc.

Doing business as Life EMS

  • Land Ambulance
  • Enid, OK
National Provider Identifier
1467455691
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
EMS075 Issued in OK
Legal business name
LIFE EMERGENCY MEDICAL SERVICE, INC.
Doing business as
Life EMS
Practice address
302 W Maple Ave
Enid, OK 73701-3808
Phone
(580) 233-2245
Fax
(580) 242-0348
NPI assigned
May 23, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

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

Authorized official

Name
Mr. James S Johnson
Title
Owner/President
Phone
(580) 233-2245

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X EMS075 OK Primary

Addresses

Primary practice location

302 W Maple Ave
Enid, OK 73701-3808

Mailing address

PO Box 365
Enid, OK 73702-0365
Phone (580) 233-2245

Other identifiers 2

IdentifierTypeStateIssuer
P00161773OtherOKRAILROAD MEDICARE #
730760393-001OtherOKBCBS PROVIDER #

Other names 1

  • Life EMS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071130000658 OK Part B Supplier - Ambulance Service Supplier 0749212785 Practice locations: Enid, OK

National Provider Directory

National Provider Directory

Locations

321 W Elm Ave
Enid, OK 73701
Phone (580) 233-2247

302 W Maple Ave
Enid, OK 73701
Phone (580) 233-2245

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192492800000",
    "number": "1467455691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 365",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737020365",
            "telephone_number": "580-233-2245",
            "fax_number": "580-242-0348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W MAPLE AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737013808",
            "telephone_number": "580-233-2245",
            "fax_number": "580-242-0348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE EMERGENCY MEDICAL SERVICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-23",
        "last_updated": "2007-10-16",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "580-233-2245",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OK",
            "license": "EMS075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE #",
            "identifier": "P00161773",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "730760393-001",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Life EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Enid, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; 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.