Town of St. John

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

0566 Issued in IN

Legal business name

TOWN OF ST. JOHN

Practice address

10955 W 93Rd Ave
Saint John, IN 46373-8824

Phone

(219) 365-6034

Fax

(219) 558-2080

NPI assigned

May 23, 2005

Reactivated

Dec 14, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Shane Adams

Title

Fire Chief

Phone

(219) 365-6034

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773014400000",
    "number": "1619970860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10955 W 93RD AVE",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "463737809",
            "telephone_number": "219-365-6034",
            "fax_number": "219-558-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10955 W 93RD AVE",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "463738824",
            "telephone_number": "219-365-6034",
            "fax_number": "219-558-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN OF ST. JOHN",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-23",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "deactivation_date": "2022-11-11",
        "reactivation_date": "2022-12-14",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "SHANE",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "219-365-6034",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IN",
            "license": "0566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200367650A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Saint John, IN
• Providers in Saint John, IN by specialty
• Land Ambulance in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2026; 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.