City of Campbellsville Ky

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

CITY OF CAMPBELLSVILLE KY

Doing business as

Campbellsville Taylor County EMS

Practice address

105 South Columbia Ave
Campbellsville, KY 42718-1337

Phone

(270) 465-6717

Fax

(270) 789-3135

NPI assigned

Jul 14, 2005

Organization subpart

No

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

Authorized official

Name

Tony Young

Title

Mayor

Phone

(270) 465-3504

Specialties & licenses 1

Addresses

Other identifiers 10

Other names 1

• Campbellsville Taylor County EMS Doing business as

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549584000000",
    "number": "1508865346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 4TH AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257011407",
            "telephone_number": "800-676-4785",
            "fax_number": "304-522-4222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 SOUTH COLUMBIA AVE",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427181337",
            "telephone_number": "270-465-6717",
            "fax_number": "270-789-3135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF CAMPBELLSVILLE KY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-14",
        "last_updated": "2019-02-08",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "TONY",
        "authorized_official_title_or_position": "MAYOR",
        "authorized_official_telephone_number": "270-465-3504"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1864176",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "086909900",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "56027774",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "2445149000",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200201650A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55001101",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00248582",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000340594",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2645221",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "1063010",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Campbellsville Taylor County EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Land Ambulance in Campbellsville, KY
• Providers in Campbellsville, KY by specialty
• Land Ambulance in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2019; 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.