City of Blairstown

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

2060900 Issued in IA

Legal business name

CITY OF BLAIRSTOWN

Practice address

205 Main St NE
Blairstown, IA 52209

Phone

(319) 454-0078

Fax

(319) 454-6709

NPI assigned

Jun 14, 2006

Last updated

Jun 23, 2008By 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

Melinda Sue Brittain, PARAMEDIC

Title

Director

Phone

(319) 454-0078

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• Blairstown Fire Dept or Blairstown Ambulance /EMS or Blairstown Rescue Other name

Medicare fee-for-service enrollment

Enrolled in IA

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

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1649213752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 LOCUST ST NW",
            "address_2": "PO BOX 270",
            "city": "BLAIRSTOWN",
            "state": "IA",
            "postal_code": "52209",
            "telephone_number": "319-454-0078",
            "fax_number": "319-454-6709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 MAIN ST NE",
            "city": "BLAIRSTOWN",
            "state": "IA",
            "postal_code": "52209",
            "telephone_number": "319-454-0078",
            "fax_number": "319-454-6709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF BLAIRSTOWN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "BRITTAIN",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "319-454-0078",
        "authorized_official_credential": "PARAMEDIC"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IA",
            "license": "2060900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0165654",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED AMER INS CO",
            "identifier": "C 16565",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRINCIPAL LIFE INS CO",
            "identifier": "001417",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BC/BS",
            "identifier": "41094",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIERRA",
            "identifier": "J09900019506",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN#",
            "identifier": "0004654218",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA-RR MEDICARE",
            "identifier": "590006388",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blairstown Fire Dept or Blairstown Ambulance /EMS or Blairstown Rescue",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Land Ambulance in Blairstown, IA
• Providers in Blairstown, IA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.