NPIMap

Organization Active NPI

Lower Brule Ambulance

  • Ambulance
  • Lower Brule, SD
National Provider Identifier
1710946348
Registry record updated Mar 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
451 Issued in SD
Legal business name
LOWER BRULE AMBULANCE
Practice address
Bia Route 3
Lower Brule, SD 57548-0817
Phone
(605) 473-5293
Fax
(605) 473-1058
NPI assigned
Mar 22, 2006
Last updated
Mar 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2008

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

Authorized official

Name
Mr. Otis Brent Doren
Title
Program Director
Phone
(605) 473-5293

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 451 SD Primary

Addresses

Primary practice location

Bia Route 3
Lower Brule, SD 57548-0817

Mailing address

187 Oyate Circle
Lower Brule, SD 57548-0187
Phone (605) 473-5293

Other identifiers 1

IdentifierTypeStateIssuer
9002150MedicaidSD

National Provider Directory

National Provider Directory
Tax ID family
Lower Brule Sioux Tribe7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206662400000",
    "number": "1710946348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 OYATE CIRCLE",
            "city": "LOWER BRULE",
            "state": "SD",
            "postal_code": "575480187",
            "telephone_number": "605-473-5293",
            "fax_number": "605-473-1058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BIA ROUTE 3",
            "city": "LOWER BRULE",
            "state": "SD",
            "postal_code": "575480817",
            "telephone_number": "605-473-5293",
            "fax_number": "605-473-1058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOWER BRULE AMBULANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-22",
        "last_updated": "2008-03-28",
        "status": "A",
        "authorized_official_last_name": "DOREN",
        "authorized_official_first_name": "OTIS",
        "authorized_official_middle_name": "BRENT",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "605-473-5293",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "SD",
            "license": "451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9002150",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lower Brule, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; 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.