NPIMap

Organization Active NPI

Colorado City Fire District

Doing business as Colorado City Fire Department

  • Land Ambulance
  • Colorado City, AZ
National Provider Identifier
1669486593
Registry record updated Dec 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
22 Issued in AZ
Legal business name
COLORADO CITY FIRE DISTRICT
Doing business as
Colorado City Fire Department
Practice address
40 South Pioneer St.
Colorado City, AZ 86021-1588
Phone
(928) 875-2400
Fax
(928) 875-2056
NPI assigned
Jul 28, 2006
Last updated
Dec 4, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2012

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

Authorized official

Name
Mr. Jake Barlow
Title
Chief
Phone
(928) 875-2400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 22 AZ Primary

Addresses

Primary practice location

40 South Pioneer St.
Colorado City, AZ 86021-1588

Mailing address

40 South Pioneer Street
PO Box 1588
Colorado City, AZ 86021-1588
Phone (928) 875-2400

Other identifiers 1

IdentifierTypeStateIssuer
071853MedicaidAZ

Other names 1

  • Colorado City Fire Department Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100310000229 AZ Part B Supplier - Ambulance Service Supplier 8224173695 Practice locations: Colorado City, AZ

National Provider Directory

National Provider Directory
Tax ID family
Colorado City Fire District2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354579200000",
    "number": "1669486593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 SOUTH PIONEER STREET",
            "address_2": "PO BOX 1588",
            "city": "COLORADO CITY",
            "state": "AZ",
            "postal_code": "860211588",
            "telephone_number": "928-875-2400",
            "fax_number": "928-875-2056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 SOUTH PIONEER ST.",
            "city": "COLORADO CITY",
            "state": "AZ",
            "postal_code": "860211588",
            "telephone_number": "928-875-2400",
            "fax_number": "928-875-2056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO CITY FIRE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2012-12-04",
        "status": "A",
        "authorized_official_last_name": "BARLOW",
        "authorized_official_first_name": "JAKE",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "928-875-2400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "AZ",
            "license": "22",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "071853",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colorado City Fire Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Colorado City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; 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.