Heyworth Ambulance Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

26737 Issued in IL

Legal business name

HEYWORTH AMBULANCE SERVICE

Practice address

707 S Vine St
Heyworth, IL 61745-0258

Phone

(309) 473-2149

Fax

(309) 473-2473

NPI assigned

Feb 13, 2007

Organization subpart

No

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

Authorized official

Name

Judy Mowery

Title

EMS Captain

Phone

(309) 261-3126

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328140800000",
    "number": "1619019072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 258",
            "address_2": "707 S VINE ST",
            "city": "HEYWORTH",
            "state": "IL",
            "postal_code": "617450258",
            "telephone_number": "309-473-2149",
            "fax_number": "309-473-2473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 S VINE ST",
            "city": "HEYWORTH",
            "state": "IL",
            "postal_code": "617450258",
            "telephone_number": "309-473-2149",
            "fax_number": "309-473-2473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEYWORTH AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2012-02-02",
        "status": "A",
        "authorized_official_last_name": "MOWERY",
        "authorized_official_first_name": "JUDY",
        "authorized_official_title_or_position": "EMS CAPTAIN",
        "authorized_official_telephone_number": "309-261-3126"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "26737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "590013395",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Heyworth, IL
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.