NPIMap

Organization Active NPI

County of Crawford

  • Land Ambulance
  • Frontenac, KS
National Provider Identifier
1730274143
Registry record updated Dec 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
460 Issued in KS
Legal business name
COUNTY OF CRAWFORD
Practice address
270 N Industrial Dr
Frontenac, KS 66763
Phone
(620) 231-3344
NPI assigned
Oct 3, 2006
Last updated
Dec 15, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2015

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

Authorized official

Name
Mr. Randy Sandberg, MICT
Title
Director EMS
Phone
(620) 231-3344

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 460 KS Primary

Addresses

Primary practice location

270 N Industrial Dr
Frontenac, KS 66763

Mailing address

P.O.Box 292
Girard, KS 66743
Phone (620) 231-3344

Other identifiers 5

IdentifierTypeStateIssuer
005563OtherKSBLUE CROSS/BLUE SHIELD
100091610DMedicaidKS
665310OtherKSFIRST GUARD
800626707MedicaidMO
826590053OtherKSR.R. MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070319000551 KS Part B Supplier - Ambulance Service Supplier 3173427747 Practice locations: Girard, KS; Pittsburg, KS

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

  • County of Crawford

    dba Community Mental Health Center of Crawford County

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Pittsburg, KS
    • NPI 1215900899

    3173427747

    Same PAC ID
  • County of Crawford

    dba Crawford County Health Department

    • Public Health or Welfare Agency
    • Pittsburg, KS
    • NPI 1437295318

    3173427747

    Same PAC ID

National Provider Directory

National Provider Directory
Tax ID family
Renewal House9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450137600000",
    "number": "1730274143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O.BOX 292",
            "city": "GIRARD",
            "state": "KS",
            "postal_code": "66743",
            "telephone_number": "620-231-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 N INDUSTRIAL DR",
            "city": "FRONTENAC",
            "state": "KS",
            "postal_code": "66763",
            "telephone_number": "620-231-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF CRAWFORD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2015-12-15",
        "status": "A",
        "authorized_official_last_name": "SANDBERG",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "DIRECTOR EMS",
        "authorized_official_telephone_number": "620-231-3344",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MICT"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "KS",
            "license": "460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "005563",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100091610D",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST GUARD",
            "identifier": "665310",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800626707",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R.R. MEDICARE",
            "identifier": "826590053",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frontenac, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2015; 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.