City of Keithsburg

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

000002555 Issued in IL

Legal business name

CITY OF KEITHSBURG

Doing business as

Volunteer Ambulance Service of Keithsburg

Practice address

202 S 6TH St
Keithsburg, IL 61442-5033

Phone

(309) 374-2220

NPI assigned

Dec 1, 2006

Last updated

May 21, 2012By 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

Judith L Brown

Title

Treasurer

Phone

(309) 374-2414

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• VOLUNTEER AMBULANCE SERVICE OF KEITHSBURG Doing business as

Locations

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337558400000",
    "number": "1710055199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 WASHINGTON ST",
            "city": "KEITHSBURG",
            "state": "IL",
            "postal_code": "614429627",
            "telephone_number": "309-374-2414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 S 6TH ST",
            "city": "KEITHSBURG",
            "state": "IL",
            "postal_code": "614425033",
            "telephone_number": "309-374-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF KEITHSBURG",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2012-05-21",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "309-374-2414"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "000002555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "362958288001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VOLUNTEER AMBULANCE SERVICE OF KEITHSBURG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.