Eastern Pennington County Ambulance District Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

0026 Issued in SD

Legal business name

EASTERN PENNINGTON COUNTY AMBULANCE DISTRICT INC

Doing business as

Wall Ambulance Service

Practice address

210 Second Avenue
Wall, SD 57790-0336

Phone

(605) 279-2663

Fax

(605) 279-2067

NPI assigned

Feb 21, 2013

Last updated

Jun 4, 2013By 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

John Kitterman

Title

Ambulance Director

Phone

(605) 279-2620

Specialties & licenses 1

Addresses

Other names 1

• WALL AMBULANCE SERVICE Doing business as

Medicare fee-for-service enrollment

Enrolled in SD

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": "1361404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370304000000",
    "number": "1689914178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 336",
            "city": "WALL",
            "state": "SD",
            "postal_code": "577900336",
            "telephone_number": "605-279-2663",
            "fax_number": "605-279-2067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 SECOND AVENUE",
            "city": "WALL",
            "state": "SD",
            "postal_code": "577900336",
            "telephone_number": "605-279-2663",
            "fax_number": "605-279-2067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN PENNINGTON COUNTY AMBULANCE DISTRICT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-21",
        "last_updated": "2013-06-04",
        "status": "A",
        "authorized_official_last_name": "KITTERMAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "AMBULANCE DIRECTOR",
        "authorized_official_telephone_number": "605-279-2620"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "SD",
            "license": "0026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WALL AMBULANCE SERVICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Badlands Physical Therapy, LLC
• Black Hills Health and Wellness Center (Black Hills Health and Wellness Center of Wall)
• City of Wall (Wall Volunteer Ambulance)
• Crystal Kay Deal
• Cynthia Sue Dinger, PHARMD
• Monument Health Rapid City Hospital, Inc. (Monument Health Wall Clinic)
• Monument Health Rapid City Hospital, Inc. (Monument Health Wall Clinic)
• David Orla Olson, CRNA
• Rapid City Regional Hospital Inc (Wall Regional Medical Clinic)
• Rapid City Regional Hospital, Inc. (Regional Health Medical Clinic)

• Land Ambulance in Wall, SD
• Providers in Wall, 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 Jun 4, 2013; 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.