Lifestar Ambulance Service,Inc.

Primary specialty

AmbulanceTaxonomy code 341600000X

License

5225 Issued in IL

Legal business name

LIFESTAR AMBULANCE SERVICE,INC.

Practice address

940 N Elm St
Centralia, IL 62801-2326

Phone

(618) 532-2474

Fax

(618) 532-7795

NPI assigned

May 19, 2006

Last updated

Jul 17, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Roger D. Campbell

Title

President

Phone

(618) 532-2474

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Lifestar Ambulance Service, Inc.

  • Ambulance
  • Springfield, IL
  • NPI 1629025051

  O20050509000773

  Same enrollment
• Lifestar Ambulance Service, Inc.

  • Ambulance
  • Jacksonville, IL
  • NPI 1780639823

  O20050509000773

  Same enrollment

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689552000000",
    "number": "1487608055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 N ELM ST",
            "address_2": "PO BOX 1838",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628012326",
            "telephone_number": "618-532-2474",
            "fax_number": "618-532-7795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 N ELM ST",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628012326",
            "telephone_number": "618-532-2474",
            "fax_number": "618-532-7795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTAR AMBULANCE SERVICE,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-532-2474"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "IL",
            "license": "5225",
            "primary": true
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lees Anesthesia Services PC
• Suzanna Lefebvre, MSW
• Audrey Lemke
• Leslie Williams Apn LLC
• Kelly Leuty, LCPC
• Sally Johonna Lindsay, LCSW
• Bailey Morgan Lindsey
• Jill Logan
• Aubrey Elizabeth Lowry, M.C.D., CCC-SLP
• LTC Illinois - Friendship, Inc. (Friendship House of Centralia)

• Ambulance in Centralia, IL
• Providers in Centralia, IL by specialty
• Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; 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.