City of Lake Preston

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

0424 Issued in SD

Legal business name

CITY OF LAKE PRESTON

Practice address

111 3Rd St NE
Lake Preston, SD 57249-0397

Phone

(605) 847-4140

Fax

(605) 847-4140

NPI assigned

Jul 31, 2006

Organization subpart

No

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

Authorized official

Name

Bonnie M Nelson

Title

President

Phone

(605) 847-4140

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• LAKE PRESTON AMBULANCE SERVICE Doing business as

Medicare fee-for-service enrollment

Enrolled in SD

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

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506643200000",
    "number": "1477569267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30177 422ND AVE",
            "city": "TYNDALL",
            "state": "SD",
            "postal_code": "57066",
            "telephone_number": "605-464-0382",
            "fax_number": "605-589-3672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 3RD ST NE",
            "city": "LAKE PRESTON",
            "state": "SD",
            "postal_code": "572490397",
            "telephone_number": "605-847-4140",
            "fax_number": "605-847-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF LAKE PRESTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2017-09-29",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "605-847-4140"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "SD",
            "license": "0424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000340",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAKE PRESTON AMBULANCE SERVICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Karen D Bumann, PA-C, RN
• Dannica Callies
• Lisa Marie Greene
• Horizon Health Care Inc
• Kingsbury Memorial Manor
• Lake Preston School District
• Samuel William Rockino, DDS

• Land Ambulance in Lake Preston, SD
• Providers in Lake Preston, SD by specialty
• Land Ambulance in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2017; 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.