Superior Air-Ground Ambulance Service of Michigan, Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

501040 Issued in MI

Legal business name

SUPERIOR AIR-GROUND AMBULANCE SERVICE OF MICHIGAN, INC

Practice address

2000 Centerwood Dr
Warren, MI 48091

Phone

(313) 832-8558

NPI assigned

May 3, 2006

Organization subpart

No

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

Authorized official

Name

Kimberly Pate Godden III

Title

Vice President

Phone

(630) 903-2401

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MI

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": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531872000000",
    "number": "1720046188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 W LAKE ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601261508",
            "telephone_number": "630-538-1887",
            "fax_number": "630-903-2835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 CENTERWOOD DR",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48091",
            "telephone_number": "313-832-8558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERIOR AIR-GROUND AMBULANCE SERVICE OF MICHIGAN, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2018-07-18",
        "status": "A",
        "authorized_official_last_name": "GODDEN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "PATE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "630-903-2401",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "3416A0800X",
            "taxonomy_group": "",
            "desc": "Ambulance, Air Transport",
            "state": "MI",
            "license": "501040",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MI",
            "license": "501040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP(HEALTH ALLIANCE PLAN)",
            "identifier": "058738",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "0E01788",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "188077058",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Irene Judith Sun, FNP, CRNA
• Sunny Medical Equipment Inc
• Sunrise Dental Center
• Sunrise Home Health Care Inc
• Sunshine Dental Center PC
• Superior Physical Therapy and Rehabilitation LLC
• Supportive Care LLC
• Supreme Dental PC
• Alma Supuk, MSW
• Sureal Loving Home Care

• Land Ambulance in Warren, MI
• Providers in Warren, MI by specialty
• Land Ambulance in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; 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.