Montgomery County Ambulance

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1445 Issued in KY

Legal business name

MONTGOMERY COUNTY AMBULANCE

Practice address

805 Indian Mound Drive
Mt Sterling, KY 40353-1151

Phone

(859) 498-1318

Fax

(859) 498-3809

NPI assigned

Jul 13, 2005

Organization subpart

No

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

Authorized official

Name

Larry Potter

Title

Chief

Phone

(859) 498-1318

Specialties & licenses 1

Addresses

Other identifiers 9

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": "1121212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300147200000",
    "number": "1780682773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 4TH AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257011407",
            "telephone_number": "800-676-4785",
            "fax_number": "304-522-4222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 INDIAN MOUND DRIVE",
            "city": "MT STERLING",
            "state": "KY",
            "postal_code": "403531151",
            "telephone_number": "859-498-1318",
            "fax_number": "859-498-3809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY COUNTY AMBULANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-13",
        "last_updated": "2011-03-15",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "859-498-1318"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "KY",
            "license": "1445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "610988811",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50005079",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200528290A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2593297",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55087043",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "56004435",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590001325",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000070315",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "606386600",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elyse Howard Miller, M.A.ED, CCC-SLP
• Mindful Connections
• Holly Elizabeth Mineer, BCBA, LBA
• Amber Mitchell
• Lica Mae Monobe, PA-C
• Montgomery County Health Department
• Montgomery County Schools
• Montgomery Family Care LLC
• Montgomery Medical Services, PLLC
• Montgomery Radiation

• Land Ambulance in Mt Sterling, KY
• Providers in Mt Sterling, KY by specialty
• Land Ambulance in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2011; 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.