Organization Active NPI

Palmerton Community Ambulance Association, Inc.

Land Ambulance
Palmerton, PA

National Provider Identifier

1760581292

Registry record updated Nov 28, 2012

On this page

Key facts
NPPES NPI Registry
Medicare participation
National Provider Directory
NPI Registry JSON
Other providers in Palmerton, PA
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Land AmbulanceTaxonomy code 3416L0300X
License: 06111PA Issued in PA
Legal business name: PALMERTON COMMUNITY AMBULANCE ASSOCIATION, INC.
Practice address: 501 Delaware Avenue
Palmerton, PA 18071-0002
Phone: (610) 826-7609
Fax: (610) 826-5327
NPI assigned: Sep 21, 2006
Organization subpart: No

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

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

Authorized official

Name: Mrs. Danielle T. Weaver
Title: Financial Officer/Board of Director
Phone: (570) 401-1279

Specialties & licenses 2

Specialty (taxonomy)	Code	License	State	Primary
Land Ambulance	3416L0300X	06111	PA
Land Ambulance	3416L0300X	06111PA	PA	Primary

Addresses

Primary practice location

501 Delaware Avenue
Palmerton, PA 18071-0002

Mailing address

PO Box 2
501 Delaware Avenue
Palmerton, PA 18071
Phone (610) 826-7809

Other identifiers 16

Identifier	Type	State	Issuer
0145827	Other	TN	BC OF TENN
0780734/01	Other	PA	MED PLUS
1528003	Other	NY	GATEWAY
50002800	Other	PA	CAP. BC
127702	Other	PA	UNISON MED PLUS
20012758	Other	PA	AMERIHEALTH MERCY
284951	Other	PA	HIGHMARK BS
74817	Other	PA	ATHEM BLUE
0025427000	Other	PA	PERSONAL CHOICE
590007582	Other	PA	RR MED
0007807340001	Medicaid	PA
31245	Other		HEALTH PARTNERS
1154979	Other	PA	KEYSTONE MERCY
808539	Other	PA	FIRST PRIOITY
002542700	Other	PA	AMERIHEALTH
2709438	Other		OXFORD

Medicare participation

Medicare enrollment files

Medicare fee-for-service enrollment: Enrolled in PA

Enrollment records 1

Enrollment ID	State	Provider type	PAC ID	Details
O20121029000145	PA	Part B Supplier - Ambulance Service Supplier	1759531700	Practice locations: Palmerton, PA

National Provider Directory

Locations

501 Delaware Ave
Palmerton, PA 18071
Phone (215) 826-7600

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354060800000",
    "number": "1760581292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2",
            "address_2": "501 DELAWARE AVENUE",
            "city": "PALMERTON",
            "state": "PA",
            "postal_code": "18071",
            "telephone_number": "610-826-7809",
            "fax_number": "610-826-5327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 DELAWARE AVENUE",
            "city": "PALMERTON",
            "state": "PA",
            "postal_code": "180710002",
            "telephone_number": "610-826-7609",
            "fax_number": "610-826-5327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMERTON COMMUNITY AMBULANCE ASSOCIATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2012-11-28",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "FINANCIAL OFFICER/BOARD OF DIRECTOR",
        "authorized_official_telephone_number": "570-401-1279",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "PA",
            "license": "06111",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "PA",
            "license": "06111PA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC OF TENN",
            "identifier": "0145827",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED PLUS",
            "identifier": "0780734/01",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "1528003",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAP. BC",
            "identifier": "50002800",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON MED PLUS",
            "identifier": "127702",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY",
            "identifier": "20012758",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BS",
            "identifier": "284951",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATHEM BLUE",
            "identifier": "74817",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL CHOICE",
            "identifier": "0025427000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MED",
            "identifier": "590007582",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007807340001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "31245",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "1154979",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIOITY",
            "identifier": "808539",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "002542700",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "2709438",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmerton, PA

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 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.