Osf Lifeline Ambulance, LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

OSF LIFELINE AMBULANCE, LLC

Practice address

318 Roxbury Rd
Rockford, IL 61107-5090

Phone

(815) 395-4695

Fax

(805) 395-4643

NPI assigned

Dec 6, 2006

Organization subpart

Yes

Parent organization

OSF HEALTHCARE SYSTEMAs reported in NPPES

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

Authorized official

Name

James M Moore

Title

Ceo

Phone

(309) 655-2850

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Osf Healthcare System

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Osf Healthcare System

  dba Osf Healthcare - Medical Group - Godfrey

  • Rural Health Clinic/Center
  • Godfrey, IL
  • NPI 1861041980

  Member Of

  NPD member

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gerald McShane

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1669553012
  NPD (past)
• Alma Padilla, LMT

  • Massage Therapist
  • Belvidere, IL
  • NPI 1588570626
  NPD (past)
• Shelli Pollard, LCSW

  • Clinical Social Worker
  • Belvidere, IL
  • NPI 1053786269
  NPD (past)

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397001600000",
    "number": "1619036829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17115",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611107115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075090",
            "telephone_number": "815-395-4695",
            "fax_number": "805-395-4643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSF LIFELINE AMBULANCE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OSF HEALTHCARE SYSTEM",
        "enumeration_date": "2006-12-06",
        "last_updated": "2014-04-09",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "309-655-2850"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "471203",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Osborne, LSW
• Trisha Osborne
• Elizabeth Oseland, RBT
• Osf Children's Medical Group - Congenital Heart Center, LLC
• Osf Healthcare System (OSF Healthcare Home Medical Equipment)
• Osf Multi-Specialty Group
• Jessica L Oslund, N.P.
• Sandra Ostendorf, PT
• Lu Ann Ostrander, APN
• Monica Krystyna Ostrowski, APRN

• Land Ambulance in Rockford, IL
• Providers in Rockford, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2014; 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.