Active NPI
City of Ottawa Illinois
- Land Ambulance
- Ottawa, IL
National Provider Identifier
1477592798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 2963
- Legal business name
- CITY OF OTTAWA ILLINOIS
- Practice address
- 301 W Lafayette St
Ottawa, IL 61350-5700 - Phone
- (815) 434-3785
- Fax
- (815) 434-3805
- NPI assigned
- Jun 5, 2006
- Last updated
- Apr 1, 2013
- 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
- Jeff Newbury
- Title
- Fire Chief
- Phone
- (815) 434-3785
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 2963 | IL | Primary |
Addresses
Primary practice location
301 W Lafayette St
Ottawa, IL 61350-5700
Mailing address
PO Box 260
Mendota, IL 61342-0260
Phone (815) 539-2468
Other names 1
- Ottawa Fire Department
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081016000216 | IL | Part B Supplier - Ambulance Service Supplier | 0547328742 | Practice locations: Ottawa, IL |
National Provider Directory
National Provider DirectoryLocations
301 W Lafayette St
Ottawa, IL 61350
Phone (815) 434-3785
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149465600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1364774400000",
"number": "1477592798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 260",
"city": "MENDOTA",
"state": "IL",
"postal_code": "613420260",
"telephone_number": "815-539-2468",
"fax_number": "815-539-6427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 W LAFAYETTE ST",
"city": "OTTAWA",
"state": "IL",
"postal_code": "613505700",
"telephone_number": "815-434-3785",
"fax_number": "815-434-3805"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CITY OF OTTAWA ILLINOIS",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-05",
"last_updated": "2013-04-01",
"status": "A",
"authorized_official_last_name": "NEWBURY",
"authorized_official_first_name": "JEFF",
"authorized_official_title_or_position": "FIRE CHIEF",
"authorized_official_telephone_number": "815-434-3785"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "IL",
"license": "2963",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Ottawa Fire Department",
"code": "4",
"type": "Former Legal Business Name"
}
]
}
Other providers in Ottawa, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2013; 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.