City of Blackwell

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

EMS031 Issued in OK

Legal business name

CITY OF BLACKWELL

Doing business as

Blackwell Fire Department Ambulance

Practice address

221 W Blackwell Ave
Blackwell, OK 74631-2807

Phone

(580) 363-7200

Fax

(580) 363-3091

NPI assigned

May 23, 2005

Last updated

Aug 22, 2020By 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

Mr. Tom Beliel

Title

Director

Phone

(580) 363-5490

Specialties & licenses 1

Addresses

Other names 1

• Blackwell Fire Department Ambulance Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528061728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 350",
            "city": "BLACKWELL",
            "state": "OK",
            "postal_code": "746310350",
            "telephone_number": "580-363-7200",
            "fax_number": "580-363-3091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W BLACKWELL AVE",
            "city": "BLACKWELL",
            "state": "OK",
            "postal_code": "746312807",
            "telephone_number": "580-363-7200",
            "fax_number": "580-363-3091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF BLACKWELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BELIEL",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "580-363-5490",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OK",
            "license": "EMS031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blackwell Fire Department Ambulance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelsey Burnett, PA-C
• Nita L Calvin, PA
• Joby V Chambers, REGISTERED NURSE
• Michelle Chan, DDS
• Amanda Kay Childers, BSN RN
• Billie Jo Claflin
• Shalynn Faith Cloud
• Diagnostic Laboratory of Oklahoma LLC
• Jennifer Dinh, DDS
• Caryen Leemarie Fergeson, RPH

• Land Ambulance in Blackwell, OK
• Providers in Blackwell, OK by specialty
• Land Ambulance in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.