NPIMap

Organization Active NPI

Wayside Emergency Team, Inc.

  • Land Ambulance
  • Wayside, TX
National Provider Identifier
1619972270
Registry record updated Jul 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
006002 Issued in TX
Legal business name
WAYSIDE EMERGENCY TEAM, INC.
Practice address
3407 Co Rd 5
Wayside, TX 79094-0131
Phone
(806) 764-3354
Fax
(806) 764-3356
NPI assigned
Jun 20, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2008

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

Authorized official

Name
Fran Stevens
Title
Treasurer
Phone
(806) 764-3354

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 006002 TX Primary

Addresses

Primary practice location

3407 Co Rd 5
Wayside, TX 79094-0131

Mailing address

PO Box 131
Wayside, TX 79094-0131
Phone (806) 764-3354

Other identifiers 2

IdentifierTypeStateIssuer
000743701MedicaidTX
AMB782OtherTXBCBS

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216166400000",
    "number": "1619972270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 131",
            "city": "WAYSIDE",
            "state": "TX",
            "postal_code": "790940131",
            "telephone_number": "806-764-3354",
            "fax_number": "806-764-3356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3407 CO RD 5",
            "city": "WAYSIDE",
            "state": "TX",
            "postal_code": "790940131",
            "telephone_number": "806-764-3354",
            "fax_number": "806-764-3356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYSIDE EMERGENCY TEAM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-20",
        "last_updated": "2008-07-16",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "FRAN",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "806-764-3354"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "TX",
            "license": "006002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000743701",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AMB782",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; 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.