Clay County Fiscal Court

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1359 Issued in KY

Legal business name

CLAY COUNTY FISCAL COURT

Doing business as

Clay County Emergency Ambulance Service

Practice address

115 Court St
Manchester, KY 40962

Phone

(606) 598-8413

Fax

(606) 598-1875

NPI assigned

Apr 28, 2006

Last updated

Jan 19, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Rodney H. Wagers

Title

EMS Director

Phone

(606) 598-8413

Specialties & licenses 1

Addresses

Other identifiers 8

Other names 1

• Clay County Emergency Ambulance Service Doing business as

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453161600000",
    "number": "1780641035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 RICHMOND RD",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "40962",
            "telephone_number": "606-598-8413",
            "fax_number": "606-598-1875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 COURT ST",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "40962",
            "telephone_number": "606-598-8413",
            "fax_number": "606-598-1875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAY COUNTY FISCAL COURT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-28",
        "last_updated": "2016-01-19",
        "status": "A",
        "authorized_official_last_name": "WAGERS",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "EMS DIRECTOR",
        "authorized_official_telephone_number": "606-598-8413",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "KY",
            "license": "1359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED MINE WORKERS",
            "identifier": "0717614",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "56003734",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT HEALTH",
            "identifier": "1069742",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55026017",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "057235700",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000331660",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "2434809000",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2577377",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clay County Emergency Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Land Ambulance in Manchester, KY
• Providers in Manchester, KY by specialty
• Land Ambulance in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2016; 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.