City of Des Peres

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

189201 Issued in MO

Legal business name

CITY OF DES PERES

Practice address

1000 N Ballas Rd
Des Peres, MO 63131-3706

Phone

(314) 822-1500

NPI assigned

Mar 16, 2006

Last updated

Feb 14, 2023By 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

Dale Fiala

Title

Assistant Fire Chief

Phone

(314) 835-6231

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676332800000",
    "number": "1700855392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12325 MANCHESTER RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631314316",
            "telephone_number": "314-835-6113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N BALLAS RD",
            "city": "DES PERES",
            "state": "MO",
            "postal_code": "631313706",
            "telephone_number": "314-822-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF DES PERES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-16",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A",
        "authorized_official_last_name": "FIALA",
        "authorized_official_first_name": "DALE",
        "authorized_official_title_or_position": "ASSISTANT FIRE CHIEF",
        "authorized_official_telephone_number": "314-835-6231"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MO",
            "license": "189201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCAREUSA PROVIDER #",
            "identifier": "19819",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805146701",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PROV. #",
            "identifier": "P00140402",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NO.",
            "identifier": "127801",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP PROVIDER NO.",
            "identifier": "29933",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE PROV. #",
            "identifier": "8181789",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Des Peres, MO
• Providers in Des Peres, MO by specialty
• Land Ambulance in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; 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.