Marthasville Community Ambulance District

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

219011 Issued in MO

Legal business name

MARTHASVILLE COMMUNITY AMBULANCE DISTRICT

Practice address

200 South Street
Marthasville, MO 63357-0182

Phone

(636) 433-5262

Fax

(636) 433-5902

NPI assigned

Dec 13, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Larry Brewe

Title

Board Chairman

Phone

(636) 433-5262

Specialties & licenses 1

Addresses

Other identifiers 4

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": "1134432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770568743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 182",
            "city": "MARTHASVILLE",
            "state": "MO",
            "postal_code": "633570182",
            "telephone_number": "636-433-5262",
            "fax_number": "636-433-5902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SOUTH STREET",
            "city": "MARTHASVILLE",
            "state": "MO",
            "postal_code": "633570182",
            "telephone_number": "636-433-5262",
            "fax_number": "636-433-5902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTHASVILLE COMMUNITY AMBULANCE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BREWE",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "BOARD CHAIRMAN",
        "authorized_official_telephone_number": "636-433-5262",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MO",
            "license": "219011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "112638",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "8181643",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "33558",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "146442",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robin Mackenzie Graumenz, RN, BSN, IBCLC
• Lauren R Hanify, PA-C
• Jenny Elizabeth Kelpe
• Stacy Kloeppel
• Timothy P Long, M.D.
• Sarah Lorraine Mehrhoff, M.P.T.
• Richard Plattner Parsons, MD
• Patients First Health Care
• Barbara Ann Wood

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.