Community Emergency Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

111003 Issued in MI

Legal business name

COMMUNITY EMERGENCY SERVICE

Doing business as

MEDIC 1 AMBULANCE

Practice address

635 E Napier Ave
Benton Harbor, MI 49022-5813

Phone

(269) 925-2144

Fax

(269) 926-1139

NPI assigned

Apr 18, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jack Fisher Jr.

Title

Director

Phone

(269) 925-2144

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MEDIC 1 AMBULANCE Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

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": "1145318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619932415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1563",
            "address_2": "635 E. NAPIER AVE.",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490231563",
            "telephone_number": "269-925-2144",
            "fax_number": "269-926-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 E NAPIER AVE",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490225813",
            "telephone_number": "269-925-2144",
            "fax_number": "269-926-1139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY EMERGENCY SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "269-925-2144",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MI",
            "license": "111003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3004228",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDIC 1 AMBULANCE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lisa R Cole, LMSW, ACSW
• Felice Coleman
• Iesha Coleman
• Brittany Collins
• Ruby Collins
• Brenda Connell
• Laila Coombs
• Jennifer Cooper-Peterson, RDH
• Anna Marie Cooper, LLMSW
• Celeas Aaron Cooper

• Land Ambulance in Benton Harbor, MI
• Providers in Benton Harbor, MI by specialty
• Land Ambulance in Michigan

• 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.