Edgemont Ambulance Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

29 Issued in SD

Legal business name

EDGEMONT AMBULANCE SERVICE

Practice address

219 2ND Street
Edgemont, SD 57735

Phone

(605) 662-7977

Fax

(605) 662-7977

NPI assigned

Oct 26, 2006

Last updated

Nov 4, 2010By 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

Brenda M Litzel, BILLING OFFICER

Title

Billing Eas

Phone

(605) 662-7416

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288828800000",
    "number": "1629153002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 212",
            "city": "EDGEMONT",
            "state": "SD",
            "postal_code": "57735",
            "telephone_number": "605-662-7977",
            "fax_number": "605-662-7977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 2ND STREET",
            "city": "EDGEMONT",
            "state": "SD",
            "postal_code": "57735",
            "telephone_number": "605-662-7977",
            "fax_number": "605-662-7977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEMONT AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2010-11-04",
        "status": "A",
        "authorized_official_last_name": "LITZEL",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BILLING EAS",
        "authorized_official_telephone_number": "605-662-7416",
        "authorized_official_credential": "BILLING OFFICER"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "SD",
            "license": "29",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9010800",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cactus Hills Retirement
• Rungkan Cleveland
• Jacqualine L Dohrmann, CRNA
• Edgemont School District 23-1
• Tamara Hughson
• Regional Health Physicians Inc (Edgemont Regional Medical Clinic)
• Regional Health Physicians Inc
• Regional Health Physicians Inc (Edgemont Regional Medical Clinic)

• Land Ambulance in Edgemont, SD
• Providers in Edgemont, SD by specialty
• Land Ambulance in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; 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.