Village of Wayne City

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

55160 Issued in IL

Legal business name

VILLAGE OF WAYNE CITY

Practice address

103 Mill Street
Wayne City, IL 62895-0176

Phone

(618) 895-2241

Fax

(618) 895-2241

NPI assigned

Jan 25, 2007

Last updated

May 17, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

VILLAGE OF WAYNE CITYAs reported in NPPES

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

Authorized official

Name

Mrs. Vickie L Slater

Title

Village of Wayne Clerk

Phone

(618) 895-2241

Specialties & licenses 1

Addresses

Other names 1

• Wayne City Ambulance Service Other name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Part of

Village of Wayne City

Locations

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337212800000",
    "number": "1750436002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 176",
            "city": "WAYNE CITY",
            "state": "IL",
            "postal_code": "628950176",
            "telephone_number": "618-895-2241",
            "fax_number": "618-895-2577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 MILL STREET",
            "city": "WAYNE CITY",
            "state": "IL",
            "postal_code": "628950176",
            "telephone_number": "618-895-2241",
            "fax_number": "618-895-2241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF WAYNE CITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VILLAGE OF WAYNE CITY",
        "enumeration_date": "2007-01-25",
        "last_updated": "2012-05-17",
        "status": "A",
        "authorized_official_last_name": "SLATER",
        "authorized_official_first_name": "VICKIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VILLAGE OF WAYNE CLERK",
        "authorized_official_telephone_number": "618-895-2241",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "55160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wayne City Ambulance Service",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lisa K Feather, PA-C
• Sherry Charlette Locey, PA-C
• Kassi Dawn McCormick, PTA
• National Healthcare of Mt Vernon Inc (Crossroads Family Medicine of Wayne City)
• National Healthcare of Mt Vernon Inc (Crossroads Family Medicine of Wayne City)
• Wayne City Community School District 100

• Land Ambulance in Wayne City, IL
• Providers in Wayne City, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2012; 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.