City of Ellsworth

Primary specialty

AmbulanceTaxonomy code 341600000X

License

2406200 Issued in IA

Legal business name

CITY OF ELLSWORTH

Doing business as

Ellsworth Fire and EMS

Practice address

1528 Dewitt St
Ellsworth, IA 50075-5006

Phone

(877) 882-9911

Fax

(877) 882-9922

NPI assigned

Jul 1, 2006

Last updated

Jun 27, 2017By 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

Mrs. Michele Smith

Title

Account Representative

Phone

(877) 882-9911

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• ELLSWORTH FIRE AND EMS Doing business as

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498521600000",
    "number": "1699704734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 310",
            "city": "ELLSWORTH",
            "state": "IA",
            "postal_code": "500750310",
            "telephone_number": "605-882-9911",
            "fax_number": "605-882-9922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1528 DEWITT ST",
            "city": "ELLSWORTH",
            "state": "IA",
            "postal_code": "500755006",
            "telephone_number": "877-882-9911",
            "fax_number": "877-882-9922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF ELLSWORTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2017-06-27",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "ACCOUNT REPRESENTATIVE",
        "authorized_official_telephone_number": "877-882-9911",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "IA",
            "license": "2406200",
            "primary": true
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IA",
            "license": "2406200",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0486381",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "38556",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ELLSWORTH FIRE AND EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2017; 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.