NPIMap

Organization Active NPI

Mercy Ambulance of Evansville Inc

Doing business as American Medical Response - AMR ; Lifeguard Emergency Medical Services

  • Ambulance
  • Harlan, KY
National Provider Identifier
1689217416
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
Legal business name
MERCY AMBULANCE OF EVANSVILLE INC
Doing business as
American Medical Response - AMR ; Lifeguard Emergency Medical Services
Lifeguard Ambulance
Practice address
420 S Main St Ste 4
Harlan, KY 40831-1909
Phone
(606) 573-2721
NPI assigned
Oct 24, 2019
Last updated
Mar 16, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
MERCY AMBULANCE OF EVANSVILLE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

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

Authorized official

Name
Brian Scott Tierney
Title
Evp, Chief Financial Officer
Phone
(833) 703-2294

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X Primary
Land Ambulance 3416L0300X

Addresses

Primary practice location

420 S Main St Ste 4
Harlan, KY 40831-1909

Mailing address

PO Box 100217
Atlanta, GA 30384-0217
Phone (800) 913-9106

Other identifiers 2

IdentifierTypeStateIssuer
7100649520MedicaidKY
7100656860MedicaidKY

Other names 2

  • American Medical Response - AMR ; Lifeguard Emergency Medical Services Doing business as
  • Lifeguard Ambulance Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050518000227 KY Part B Supplier - Ambulance Service Supplier 2365405487 6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Prestonsburg, KY; Pikeville, KY; Owensboro, KY; Hyden, KY; Harlan, KY; Cumberland, KY; MC Dowell, KY

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D2162418Mercy Ambulance of Evansville, Inc D/B/a420 S Main Street Suite 4, Harlan, KY 40831Certificate of waiverFeb 20, 2027

National Provider Directory

National Provider Directory
Tax ID family
Mercy Amb Evansville Inc6 organizations share this tax ID, including this one
Part of
Mercy Amb Evansville Inc

Other organizations with this tax ID 5

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

Locations

807 E Franklin St
Evansville, IN 47711
Phone (812) 428-2211

4620 W 84th St
Ste 100
Indianapolis, IN 46268
Phone (317) 616-2166

420 S Main St
#4
Harlan, KY 40831
Phone (606) 573-2721

800 Floyd Dr
Ste D
Lexington, KY 40505
Phone (859) 259-0862

1730 E 18th St
Owensboro, KY 42303
Phone (270) 297-3461

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1571875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773619200000",
    "number": "1689217416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100217",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303840217",
            "telephone_number": "800-913-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S MAIN ST STE 4",
            "city": "HARLAN",
            "state": "KY",
            "postal_code": "408311909",
            "telephone_number": "606-573-2721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY AMBULANCE OF EVANSVILLE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY AMBULANCE OF EVANSVILLE INC",
        "enumeration_date": "2019-10-24",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A",
        "authorized_official_last_name": "TIERNEY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "EVP, CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "833-703-2294"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100649520",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100656860",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "American Medical Response - AMR ; Lifeguard Emergency Medical Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "American Medical Response - AMR ; Lifeguard Emergency Medical Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lifeguard Ambulance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harlan, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; 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.