Organization Active NPI

City of Ottawa Illinois

  • Land Ambulance
  • Ottawa, IL
National Provider Identifier
1477592798
Registry record updated Apr 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
2963 Issued in IL
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, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2013

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)CodeLicenseStatePrimary
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 Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081016000216 IL Part B Supplier - Ambulance Service Supplier 0547328742 Practice locations: Ottawa, IL

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.