Active NPI
Costilla County Ambulance District
- Land Ambulance
- San Luis, CO
National Provider Identifier
1699912592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- Legal business name
- COSTILLA COUNTY AMBULANCE DISTRICT
- Practice address
- 233 Main St.
San Luis, CO 81152-0035 - Phone
- (719) 672-4271
- Fax
- (719) 672-4277
- NPI assigned
- Jan 14, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sherri Vigil
- Title
- Assistant Director
- Phone
- (719) 580-2031
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | Primary |
Addresses
Primary practice location
233 Main St.
San Luis, CO 81152-0035
Mailing address
PO Box 9150
Paducah, KY 42002-9150
Phone (270) 744-9600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40029077 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090409000652 | CO | Part B Supplier - Ambulance Service Supplier | 6406903376 | Practice locations: San Luis, CO |
National Provider Directory
National Provider Directory- Tax ID family
- Costilla Cty Amb District
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Land Ambulance
- San Luis, CO
- NPI 1043840051
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231891200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1754438400000",
"number": "1699912592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9150",
"city": "PADUCAH",
"state": "KY",
"postal_code": "420029150",
"telephone_number": "270-744-9600",
"fax_number": "270-744-8642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "233 MAIN ST.",
"city": "SAN LUIS",
"state": "CO",
"postal_code": "811520035",
"telephone_number": "719-672-4271",
"fax_number": "719-672-4277"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COSTILLA COUNTY AMBULANCE DISTRICT",
"organizational_subpart": "NO",
"enumeration_date": "2009-01-14",
"last_updated": "2025-08-06",
"certification_date": "2025-08-06",
"status": "A",
"authorized_official_last_name": "VIGIL",
"authorized_official_first_name": "SHERRI",
"authorized_official_title_or_position": "ASSISTANT DIRECTOR",
"authorized_official_telephone_number": "719-580-2031"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40029077",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Luis, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; 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.