Active NPI
Gulfport Ambulance Service
- Land Ambulance
- Carman, IL
National Provider Identifier
1467664938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 1770779
- Legal business name
- GULFPORT AMBULANCE SERVICE
- Practice address
- RR 1 Box 84
Carman, IL 61425-9718 - Phone
- (309) 873-2575
- NPI assigned
- May 4, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Ed Ronner
- Title
- Director
- Phone
- (309) 873-2575
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 1770779 | IL | Primary |
Addresses
Primary practice location
RR 1 Box 84
Carman, IL 61425-9718
Mailing address
RR 1 Box 84
Carman, IL 61425-9718
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1218499200000",
"number": "1467664938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "RR 1 BOX 84",
"city": "CARMAN",
"state": "IL",
"postal_code": "614259718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "RR 1 BOX 84",
"city": "CARMAN",
"state": "IL",
"postal_code": "614259718",
"telephone_number": "309-873-2575"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GULFPORT AMBULANCE SERVICE",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-04",
"last_updated": "2008-08-12",
"status": "A",
"authorized_official_last_name": "RONNER",
"authorized_official_first_name": "ED",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "309-873-2575",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "IL",
"license": "1770779",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.