Erickson Ambulance LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

6000405 Issued in WI

Legal business name

ERICKSON AMBULANCE LLC

Practice address

9850 W 190TH St
Suite B-10
Mokena, IL 60448-5604

Phone

(708) 995-1192

NPI assigned

Oct 5, 2015

Last updated

Oct 5, 2015By 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

Christi Vogrig

Title

Director of Patient Accounts

Phone

(708) 995-1192

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1444003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444003200000",
    "number": "1508236431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9850 W 190TH ST STE B-10",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604485604",
            "telephone_number": "708-995-1192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9850 W 190TH ST",
            "address_2": "SUITE B-10",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604485604",
            "telephone_number": "708-995-1192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERICKSON AMBULANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-05",
        "last_updated": "2015-10-05",
        "status": "A",
        "authorized_official_last_name": "VOGRIG",
        "authorized_official_first_name": "CHRISTI",
        "authorized_official_title_or_position": "DIRECTOR OF PATIENT ACCOUNTS",
        "authorized_official_telephone_number": "708-995-1192"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WI",
            "license": "6000405",
            "primary": true
        },
        {
            "code": "343800000X",
            "taxonomy_group": "",
            "desc": "Secured Medical Transport (VAN)",
            "state": "WI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41320700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.