Paladin Medical Transport, Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1261 Issued in VA

Legal business name

PALADIN MEDICAL TRANSPORT, INC.

Practice address

1201 W. Third Street
Farmville, VA 23901-2646

Phone

(434) 315-5620

Fax

(434) 315-5840

NPI assigned

Sep 14, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Karen M Haddaway

Title

Owner

Phone

(434) 315-5620

Specialties & licenses 2

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244678400000",
    "number": "1538264262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 W. THIRD STREET",
            "city": "FARMVILLE",
            "state": "VA",
            "postal_code": "239012646",
            "telephone_number": "434-315-5620",
            "fax_number": "434-315-5840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 W. THIRD STREET",
            "city": "FARMVILLE",
            "state": "VA",
            "postal_code": "239012646",
            "telephone_number": "434-315-5620",
            "fax_number": "434-315-5840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALADIN MEDICAL TRANSPORT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2009-06-11",
        "status": "A",
        "authorized_official_last_name": "HADDAWAY",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "434-315-5620",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "VA",
            "license": "1261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010396328",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO",
            "identifier": "P00387956",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "249442",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2009; 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.