Advance EMS, LTD.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

300258 Issued in TX

Legal business name

ADVANCE EMS, LTD.

Practice address

5018 Chancellor Row
Corpus Christi, TX 78416-2106

Phone

(361) 857-2059

Fax

(361) 857-0439

NPI assigned

Jul 15, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Marina Kislyuk

Title

General Manager

Phone

(713) 661-3443

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

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

CLIA laboratory certificates

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369958400000",
    "number": "1609892272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 668",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774020668",
            "telephone_number": "713-661-3443",
            "fax_number": "713-661-3830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5018 CHANCELLOR ROW",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784162106",
            "telephone_number": "361-857-2059",
            "fax_number": "361-857-0439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE EMS, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2013-05-31",
        "status": "A",
        "authorized_official_last_name": "KISLYUK",
        "authorized_official_first_name": "MARINA",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "713-661-3443",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "333300000X",
            "taxonomy_group": "",
            "desc": "Emergency Response System Companies",
            "state": "TX",
            "license": "PP234",
            "primary": false
        },
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "TX",
            "license": "300358",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "TX",
            "license": "300258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190687701",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF TEXAS",
            "identifier": "AMB538",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000729601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Corpus Christi, TX
• Land Ambulance in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2013; 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.