City of Jesup

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1002 Issued in IA

Legal business name

CITY OF JESUP

Doing business as

Jesup Ambulance Service

Practice address

601 Young St
Jesup, IA 50648-1176

Phone

(515) 887-3553

Fax

(515) 887-2000

NPI assigned

Dec 29, 2006

Last updated

Oct 19, 2007By 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

Yalonda Amonson

Title

Account Manager

Phone

(515) 887-3553

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jesup Ambulance Service Doing business as

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Locations

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192752000000",
    "number": "1619033990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 592",
            "city": "JESUP",
            "state": "IA",
            "postal_code": "506480592",
            "telephone_number": "515-887-3553",
            "fax_number": "515-887-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 YOUNG ST",
            "city": "JESUP",
            "state": "IA",
            "postal_code": "506481176",
            "telephone_number": "515-887-3553",
            "fax_number": "515-887-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF JESUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-10-19",
        "status": "A",
        "authorized_official_last_name": "AMONSON",
        "authorized_official_first_name": "YALONDA",
        "authorized_official_title_or_position": "ACCOUNT MANAGER",
        "authorized_official_telephone_number": "515-887-3553"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IA",
            "license": "1002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0156851",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jesup Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Land Ambulance in Jesup, IA
• Providers in Jesup, IA by specialty
• Land Ambulance in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; 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.