Florissant Valley Fire Pro Dist

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

189472 Issued in MO

Legal business name

FLORISSANT VALLEY FIRE PRO DIST

Practice address

605 Saint Catherine St
Florissant, MO 63031-4946

Phone

(800) 538-8278

Fax

(580) 628-2273

NPI assigned

Oct 18, 2006

Organization subpart

No

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

Authorized official

Name

Mark Flauter

Title

Chief Medical Officer

Phone

(800) 538-8278

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713398400000",
    "number": "1720169303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 SAINT CATHERINE ST",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630314946",
            "telephone_number": "800-538-8278",
            "fax_number": "580-628-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 SAINT CATHERINE ST",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630314946",
            "telephone_number": "800-538-8278",
            "fax_number": "580-628-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORISSANT VALLEY FIRE PRO DIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A",
        "authorized_official_last_name": "FLAUTER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "800-538-8278"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MO",
            "license": "189472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805125903",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "129152",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC PROVIDER NUMBER",
            "identifier": "590014098",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Florissant Medical Rehab Group LLC
• Florissant Pediatrics Inc
• Florissant Psychological Services, Inc.
• Florissant Retirement Investors, LLC
• Florissant Skilled Nursing, LLC
• Florssant County OB-GYN
• Flourish Home Health LLC
• Tashauna Deniesha Flutch, CNA
• Jada L Fonville-Simmons
• For the Love of Helen Mae LLC

• Land Ambulance in Florissant, MO
• Providers in Florissant, MO by specialty
• Land Ambulance in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.