Town of Indian Beach

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1238 Issued in NC

Legal business name

TOWN OF INDIAN BEACH

Doing business as

Indian Beach Salter Path Fire Dept

Practice address

1410 Salter Path Rd
Indian Beach, NC 28512-5921

Phone

(252) 247-7994

NPI assigned

Jun 14, 2006

Last updated

Sep 15, 2022By 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

James B Whitley

Title

EMS Director

Phone

(252) 247-7994

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• INDIAN BEACH SALTER PATH FIRE DEPT Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• County of Carteret Courthouse Square Finance Office

  • Land Ambulance
  • Morehead City, NC
  • NPI 1568628006

  Member Of

  NPD member

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663200000000",
    "number": "1518900513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 SALTER PATH RD",
            "city": "INDIAN BEACH",
            "state": "NC",
            "postal_code": "285125921",
            "telephone_number": "252-247-7994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 SALTER PATH RD",
            "city": "INDIAN BEACH",
            "state": "NC",
            "postal_code": "285125921",
            "telephone_number": "252-247-7994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN OF INDIAN BEACH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A",
        "authorized_official_last_name": "WHITLEY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "EMS DIRECTOR",
        "authorized_official_telephone_number": "252-247-7994"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NC",
            "license": "1238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3406828",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INDIAN BEACH SALTER PATH FIRE DEPT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kenneth George Young, LCSW

• Land Ambulance in Indian Beach, NC
• Providers in Indian Beach, NC by specialty
• Land Ambulance in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; 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.