Organization Active NPI

City of West Liberty

  • Land Ambulance
  • West Liberty, IA
National Provider Identifier
1588705206
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
CITY OF WEST LIBERTY
Practice address
109 E 2ND St
West Liberty, IA 52776-1500
Phone
(319) 627-2303
Fax
(319) 627-2329
NPI assigned
Feb 8, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Ms. Joan Betthauser, NREMTP
Title
EMS Coordinator
Phone
(563) 880-2382

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X IA Primary

Addresses

Primary practice location

109 E 2ND St
West Liberty, IA 52776-1500

Mailing address

409 N Calhoun St
West Liberty, IA 52776-1344
Phone (319) 627-2418

Other identifiers 1

IdentifierTypeStateIssuer
1588705206MedicaidIA

Other names 1

  • West Liberty Volunteer Fire/EMS Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120718000562 IA Part B Supplier - Ambulance Service Supplier 4486810546 Practice locations: West Liberty, IA

National Provider Directory

National Provider Directory
Tax ID family
City of West Liberty2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

312 E 5th St
Muscatine, IA 52761
Phone (563) 262-4159

409 N Calhoun St
West Liberty, IA 52776
Phone (319) 627-2418

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1588705206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 N CALHOUN ST",
            "city": "WEST LIBERTY",
            "state": "IA",
            "postal_code": "527761344",
            "telephone_number": "319-627-2418",
            "fax_number": "319-627-4847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 E 2ND ST",
            "city": "WEST LIBERTY",
            "state": "IA",
            "postal_code": "527761500",
            "telephone_number": "319-627-2303",
            "fax_number": "319-627-2329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF WEST LIBERTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BETTHAUSER",
        "authorized_official_first_name": "JOAN",
        "authorized_official_title_or_position": "EMS COORDINATOR",
        "authorized_official_telephone_number": "563-880-2382",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NREMTP"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1588705206",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Liberty Volunteer Fire/EMS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in West Liberty, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.