Medstar Ambulance of Mendocino County Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

MEDSTAR AMBULANCE OF MENDOCINO COUNTY INC

Practice address

960 N State St
Ukiah, CA 95482-3412

Phone

(707) 462-3809

NPI assigned

Dec 15, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Leonard William Winter

Title

Chief Executive Officer

Phone

(707) 462-3808

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

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

{
    "created_epoch": "1323907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714953600000",
    "number": "1518236876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 N STATE ST",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954823412",
            "telephone_number": "707-462-3808",
            "fax_number": "707-462-9561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 N STATE ST",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954823412",
            "telephone_number": "707-462-3809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSTAR AMBULANCE OF MENDOCINO COUNTY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-15",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A",
        "authorized_official_last_name": "WINTER",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "707-462-3808",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Ukiah, CA
• Providers in Ukiah, CA by specialty
• Land Ambulance in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; 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.