Mitchell County Ambulance Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

MITCHELL COUNTY AMBULANCE SERVICE

Practice address

997 W Interstate 20
Colorado City, TX 79512-2685

Phone

(325) 728-3431

Fax

(325) 728-8974

NPI assigned

Jul 12, 2005

Last updated

May 30, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

MITCHELL COUNTY HOSPITAL DISTRICTAs reported in NPPES

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

Authorized official

Name

Suzanne Michelle Gafford

Title

Ceo

Phone

(325) 728-3431

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Mitchell County EMS Other name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Part of

Sweetwater Family Medical Associates

Locations

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717027200000",
    "number": "1598763708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "997 W INTERSTATE 20",
            "city": "COLORADO CITY",
            "state": "TX",
            "postal_code": "795122685",
            "telephone_number": "325-728-3431",
            "fax_number": "325-728-8974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "997 W INTERSTATE 20",
            "city": "COLORADO CITY",
            "state": "TX",
            "postal_code": "795122685",
            "telephone_number": "325-728-3431",
            "fax_number": "325-728-8974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MITCHELL COUNTY AMBULANCE SERVICE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MITCHELL COUNTY HOSPITAL DISTRICT",
        "enumeration_date": "2005-07-12",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-16",
        "status": "A",
        "authorized_official_last_name": "GAFFORD",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "325-728-3431"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "TX",
            "license": "168002",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "086489401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mitchell County EMS",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Mitchell County EMS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kristi Lee Manor Inc
• Virginia S Maggard
• Kaylee Martin
• Michael Steven McAndrew, O.D.
• Michael S. White
• Mitchell County Hospital
• Mitchell County Hospital District
• Mitchell County Hospital District
• Mitchell County Hospital District (Mitchell County Nursing & Rehabilitation Center)
• Mitchell County Hospital District (Family Medical Associates)

• Land Ambulance in Colorado City, TX
• Providers in Colorado City, TX by specialty
• Land Ambulance in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; 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.