Active NPI
Medical Transport Management, Inc
- Land Ambulance
- Dermott, AR
National Provider Identifier
1780119610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 0470
- Legal business name
- MEDICAL TRANSPORT MANAGEMENT, INC
- Practice address
- 109 W Peddicord St
Dermott, AR 71638-2115 - Phone
- (870) 538-3900
- Fax
- (870) 538-3902
- NPI assigned
- Apr 28, 2017
- Last updated
- Apr 28, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jim L Dintelman, EMT
- Title
- Ceo/Owner
- Phone
- (870) 538-3900
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 0470 | AR | Primary |
Addresses
Primary practice location
109 W Peddicord St
Dermott, AR 71638-2115
Mailing address
109 W Peddicord St
Dermott, AR 71638-2115
Phone (870) 538-3900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170720001344 | AR | Part B Supplier - Ambulance Service Supplier | 2668742834 | Practice locations: Dermott, AR |
National Provider Directory
National Provider DirectoryLocations
109 W Peddicord St
Dermott, AR 71638
Phone (870) 538-3900
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493337600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1493337600000",
"number": "1780119610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 W PEDDICORD ST",
"city": "DERMOTT",
"state": "AR",
"postal_code": "716382115",
"telephone_number": "870-538-3900",
"fax_number": "870-538-3902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 W PEDDICORD ST",
"city": "DERMOTT",
"state": "AR",
"postal_code": "716382115",
"telephone_number": "870-538-3900",
"fax_number": "870-538-3902"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDICAL TRANSPORT MANAGEMENT, INC",
"organizational_subpart": "NO",
"enumeration_date": "2017-04-28",
"last_updated": "2017-04-28",
"status": "A",
"authorized_official_last_name": "DINTELMAN",
"authorized_official_first_name": "JIM",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "CEO/OWNER",
"authorized_official_telephone_number": "870-538-3900",
"authorized_official_credential": "EMT"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "AR",
"license": "0470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dermott, AR
- Mainline Health Systems Inc (Mainline Dermott Medical Clinic)
- Mainline Health Systems, Inc (Mainline Dermott Dental Clinic)
- Mainline Health Systems, Inc (Dermott School Clinic)
- Mainline Health Systems, Inc (Dermott School Dental Clinic)
- Marvin D. Loyd, DDS
- Medical Transport Management, LLC
- Dana Shea Phillips, FNP-BC
- Professional Pharmacy Services Inc
- Professional Pharmacy Services Inc. (Perry Drug)
- Saving Grace Healthcare (Saving Grace Home Health Care)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2017; 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.