Village of Maryville

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

4 4868 Issued in IL

Legal business name

VILLAGE OF MARYVILLE

Practice address

300 N Donk Ave
Maryville, IL 62062-2041

Phone

(618) 344-8099

Fax

(618) 344-2990

NPI assigned

May 27, 2006

Organization subpart

No

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

Authorized official

Name

Douglas Dankenbring

Title

Fire Chief

Phone

(618) 344-8099

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Maryville Village Fire Dept Ambulance Service Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753228800000",
    "number": "1770530727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 N CENTER ST",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625671",
            "telephone_number": "800-962-1484",
            "fax_number": "513-772-4464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N DONK AVE",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620622041",
            "telephone_number": "618-344-8099",
            "fax_number": "618-344-2990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF MARYVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A",
        "authorized_official_last_name": "DANKENBRING",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "618-344-8099"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "4 4868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO RR MEDICARE",
            "identifier": "590007562",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "6032131",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL OWCP",
            "identifier": "216357500",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maryville Village Fire Dept Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Uptown Emergency Physicians LLP
• Uptown Emergency Physicians, LLP
• Mary Vaughn, PT
• Patricia Renee Verdu, RN,CNOR,RNFA
• Christina Vermaux, MS, CCC-SLP/L
• Ashley N. Wagner, DOT
• Walgreen Co
• Walgreen Co.
• Kathi Wallace, L.C.P.C.
• Barbara A. Walls

• All providers in Maryville, IL
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; 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.