Cannon County Ambulance Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

CANNON COUNTY AMBULANCE SERVICE

Practice address

104 Alexander Dr
Woodbury, TN 37190-5275

Phone

(615) 563-5959

Fax

(615) 563-6878

NPI assigned

Feb 9, 2006

Last updated

Jun 21, 2022By 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

Justin Harris

Title

Director

Phone

(615) 653-2655

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655769600000",
    "number": "1710950704",
    "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": "104 ALEXANDER DR",
            "city": "WOODBURY",
            "state": "TN",
            "postal_code": "371905275",
            "telephone_number": "615-563-5959",
            "fax_number": "615-563-6878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANNON COUNTY AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-09",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "615-653-2655"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENN CARE NON EMERGENCY",
            "identifier": "2007454",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3525445",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENN CARE EMERGENCY",
            "identifier": "4110424",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4110424",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Botanical Emergency Physicians, LLC
• Samantha Bowers, APRN
• Andrew P Bucher, D.D.S.
• Jessica Mae Cadle
• Amy L Campbell, RN
• Cannon County Board of Education
• Cannon County Chiropractic, PLLC
• Cannon County Healthcare PC (Woodbury Medical Center)
• Cannon County Hospital LLC
• Cannon County Hospital LLC (Stones River Hospital)

• Land Ambulance in Woodbury, TN
• Providers in Woodbury, TN by specialty
• Land Ambulance in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.