City of Crestwood

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

CITY OF CRESTWOOD

Doing business as

Crestwood Fire Department

Practice address

1 Detjen Dr
Saint Louis, MO 63126-1697

Phone

(314) 729-4743

NPI assigned

Jul 25, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Larry Ostertag

Title

Deputy Chief / Cmo

Phone

(131) 472-9474

Specialties & licenses 1

Addresses

Other names 1

• Crestwood Fire Department Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

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

{
    "created_epoch": "1690243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692835200000",
    "number": "1588345433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DETJEN DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631261697",
            "telephone_number": "314-729-4743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DETJEN DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631261697",
            "telephone_number": "314-729-4743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF CRESTWOOD",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-25",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A",
        "authorized_official_last_name": "OSTERTAG",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "DEPUTY CHIEF / CMO",
        "authorized_official_telephone_number": "131-472-9474",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crestwood Fire Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeffrey H Citrin, DC
• Giordano Fabricio Cittolin Santos, MD PHD
• City Cares CDS LLC
• City Chiropractic LLC
• City Diagnostics LLC
• City of St Louis
• City of St Louis (City of St Louis Fire Department)
• City of St. Louis
• City of St. Louis Department of Health (Lead Safe St. Louis)
• City Smiles Clayton, LLC

• Land Ambulance in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Land Ambulance in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; 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.