Southgate Wilder Emergency Medical Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1539 Issued in KY

Legal business name

SOUTHGATE WILDER EMERGENCY MEDICAL SERVICE

Practice address

836 4TH Ave
Huntington, WV 25701-1407

Phone

(304) 521-1576

NPI assigned

Jul 18, 2013

Organization subpart

No

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

Authorized official

Name

Anthony Kramer

Title

Director

Phone

(859) 441-1422

Specialties & licenses 1

Addresses

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": "1374105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374105600000",
    "number": "1538501614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 ELECTRIC AVE",
            "city": "SOUTHGATE",
            "state": "KY",
            "postal_code": "410713166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 4TH AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257011407",
            "telephone_number": "304-521-1576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHGATE WILDER EMERGENCY MEDICAL SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-18",
        "last_updated": "2013-07-18",
        "status": "A",
        "authorized_official_last_name": "KRAMER",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "859-441-1422"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "KY",
            "license": "1539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martha A. Sommers, MD
• Shiyi Jeffrey Song, M.D.
• Jessica Sorenson, MA
• Clara Rashawn Sorrells
• Jason R Southall, PA-C
• Southwestern Community Action Council
• Southwestern Community Action Council Inc
• Southwestern Community Action Council Inc.
• Joshua Adam Sova, RN
• Betty Sowards

• Land Ambulance in Huntington, WV
• Providers in Huntington, WV by specialty
• Land Ambulance in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2013; 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.