Salt River Ambulance District

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

205001 Issued in MO

Legal business name

SALT RIVER AMBULANCE DISTRICT

Practice address

202 N Jackson St
Shelbyville, MO 63469-1020

Phone

(573) 633-2335

Fax

(573) 633-1009

NPI assigned

Aug 10, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lucy A Bevill III

Title

Administrator

Phone

(573) 633-2335

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609877760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 N JACKSON ST",
            "city": "SHELBYVILLE",
            "state": "MO",
            "postal_code": "634691020",
            "telephone_number": "573-633-2335",
            "fax_number": "573-633-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 N JACKSON ST",
            "city": "SHELBYVILLE",
            "state": "MO",
            "postal_code": "634691020",
            "telephone_number": "573-633-2335",
            "fax_number": "573-633-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALT RIVER AMBULANCE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BEVILL",
        "authorized_official_first_name": "LUCY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "573-633-2335",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MO",
            "license": "205001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Finding Hope LLC
• Logan Brooke McKenzie
• North Shelby School District
• One Breath Mindset, LLC
• Mary Kay Rich, CCC-SLP
• Shelby County Health Dept & Home Health Agency
• Lilly K. White, L.C.S.W.

• Land Ambulance in Shelbyville, MO
• Providers in Shelbyville, 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 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.