Organization Active NPI

Asbury Community Fire Department

  • Land Ambulance
  • Asbury, IA
National Provider Identifier
1477583623
Registry record updated Feb 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
ASBURY COMMUNITY FIRE DEPARTMENT
Practice address
5485 Saratoga Rd
Asbury, IA 52002-2501
Phone
(563) 556-5874
NPI assigned
Jul 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2013

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

Authorized official

Name
Brad Kruse
Title
Chief
Phone
(563) 556-5874

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

5485 Saratoga Rd
Asbury, IA 52002-2501

Mailing address

5485 Saratoga Rd
Asbury, IA 52002-2501

Other identifiers 2

IdentifierTypeStateIssuer
0155721MedicaidIA
BCBSOtherIA15572

Other names 1

  • Asbury Fire Department Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061018000557 IA Part B Supplier - Ambulance Service Supplier 3779589536 Practice locations: Asbury, IA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D0928132Asbury Community Fire Department5485 Saratoga Road, Asbury, IA 52002Certificate of waiverMay 8, 2027

National Provider Directory

National Provider Directory

Locations

5485 Saratoga Rd
Asbury, IA 52002
Phone (563) 556-5874

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360627200000",
    "number": "1477583623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5485 SARATOGA RD",
            "city": "ASBURY",
            "state": "IA",
            "postal_code": "520022501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5485 SARATOGA RD",
            "city": "ASBURY",
            "state": "IA",
            "postal_code": "520022501",
            "telephone_number": "563-556-5874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASBURY COMMUNITY FIRE DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2013-02-12",
        "status": "A",
        "authorized_official_last_name": "KRUSE",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "563-556-5874"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0155721",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "15572",
            "identifier": "BCBS",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Asbury Fire Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Asbury, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2013; 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.