NPIMap

Organization Active NPI

County of Morton

  • Land Ambulance
  • Elkhart, KS
National Provider Identifier
1700989092
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
1340 Issued in KS
Legal business name
COUNTY OF MORTON
Practice address
722 Stevens Avenue
Elkhart, KS 67950
Phone
(620) 697-4251
Fax
(620) 697-4261
NPI assigned
Sep 5, 2006
Organization subpart
Yes
Parent organization
COUNTY OF MORTONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 31, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dusty Brillhart, DIRECTOR
Title
Supervisor
Phone
(620) 697-4251

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 1340 KS Primary

Addresses

Primary practice location

722 Stevens Avenue
Elkhart, KS 67950

Mailing address

PO Box 863
Elkhart, KS 67950-0863
Phone (620) 697-4251

Other identifiers 3

IdentifierTypeStateIssuer
100092080BMedicaidKS
112035OtherKSBLUE CROSS BLUE SHIELD KS
392750OtherKSFIRST GUARD

Other names 1

  • County of Morton Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070515000581 KS Part B Supplier - Ambulance Service Supplier 3577510650 Practice locations: Elkhart, KS

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D2129149Morton County EMS722 S Stevens Ave, Elkhart, KS 67950Certificate of waiverApr 12, 2027

National Provider Directory

National Provider Directory
Tax ID family
Morton County EMS2 organizations share this tax ID, including this one
Part of
Morton County EMS

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 4

Organizations listed as members of this organization in the National Provider Directory.

Locations

722 E Stevens St
Elkhart, KS 67950
Phone (620) 697-4251

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Morton County HospitalElkhart, KS, CCN 171386 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 16, 1968
Morton County EMSElkhart, KS, CCN 17Z386 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 16, 1968
Morton County EMSElkhart, KS, CCN 17M386 Hospital Other Jan 1, 1966
Rolla Medical ClinicRolla, KS, CCN 178602 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 16, 1968

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598832000000",
    "number": "1700989092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863",
            "city": "ELKHART",
            "state": "KS",
            "postal_code": "679500863",
            "telephone_number": "620-697-4251",
            "fax_number": "620-697-4261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 STEVENS AVENUE",
            "city": "ELKHART",
            "state": "KS",
            "postal_code": "67950",
            "telephone_number": "620-697-4251",
            "fax_number": "620-697-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF MORTON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF MORTON",
        "enumeration_date": "2006-09-05",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A",
        "authorized_official_last_name": "BRILLHART",
        "authorized_official_first_name": "DUSTY",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "620-697-4251",
        "authorized_official_credential": "DIRECTOR"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "KS",
            "license": "1340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100092080B",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD KS",
            "identifier": "112035",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST GUARD",
            "identifier": "392750",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "County of Morton",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Elkhart, KS

Sources for this page

Verify at the official NPI Registry.