Dekalb Clinton Ambulance District No 1

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

063002 Issued in MO

Legal business name

DEKALB CLINTON AMBULANCE DISTRICT NO 1

Practice address

261 SE Offutt Rd
PO 501
Maysville, MO 64469-9149

Phone

(816) 669-3642

Fax

(816) 669-3642

NPI assigned

Jun 30, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Rose L Barnes

Title

Supervisor

Phone

(816) 669-3642

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480636800000",
    "number": "1477550937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 SE OFFUTT RD",
            "address_2": "PO BOX 501",
            "city": "MAYSVILLE",
            "state": "MO",
            "postal_code": "644699149",
            "telephone_number": "816-669-3642",
            "fax_number": "816-669-3642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 SE OFFUTT RD",
            "address_2": "PO 501",
            "city": "MAYSVILLE",
            "state": "MO",
            "postal_code": "644699149",
            "telephone_number": "816-669-3642",
            "fax_number": "816-669-3642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEKALB CLINTON AMBULANCE DISTRICT NO 1",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-30",
        "last_updated": "2016-12-02",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "ROSE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "816-669-3642",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MO",
            "license": "063002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA CHAMPUS",
            "identifier": "T02666154",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "08167011",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590077838A",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bristol Care, Inc.
• Cameron Regional Medical Center Inc
• Srivani Chunchulu, M.D.
• Dekalb County Reorganized School District R-I
• Dekalb County Senate Bill 40
• N & R of Maysville, LLC
• Ginger R Neill Bundy, COTA/L
• Northwest Family Health, Inc.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2016; 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.