County of Campbell

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

COUNTY OF CAMPBELL

Practice address

136 North Massachusetts Ave
Lafollette, TN 37766

Phone

(423) 562-6201

Fax

(423) 562-0535

NPI assigned

Nov 7, 2006

Last updated

May 15, 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

Bruce Perkins

Title

Director

Phone

(423) 562-6151

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Campbell County EMS Other name

Medicare fee-for-service enrollment

Enrolled in TN

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

Locations

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494806400000",
    "number": "1699844399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843",
            "city": "JACKSBORO",
            "state": "TN",
            "postal_code": "37757",
            "telephone_number": "423-562-6201",
            "fax_number": "423-562-0535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 NORTH MASSACHUSETTS AVE",
            "city": "LAFOLLETTE",
            "state": "TN",
            "postal_code": "37766",
            "telephone_number": "423-562-6201",
            "fax_number": "423-562-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF CAMPBELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2017-05-15",
        "status": "A",
        "authorized_official_last_name": "PERKINS",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "423-562-6151"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "TN",
            "license": "EMS0000000701",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "TN",
            "license": "EMS0000000701",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3574449",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Campbell County EMS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Land Ambulance in La Follette, TN
• Providers in La Follette, TN by specialty
• Land Ambulance in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2017; 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.