Millstadt Ambulance Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

34 Issued in IL

Legal business name

MILLSTADT AMBULANCE SERVICE

Practice address

100 E Laurel St
Millstadt, IL 62260-1510

Phone

(618) 476-1201

NPI assigned

Mar 21, 2007

Last updated

Feb 7, 2026By 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

Jennifer Marie Goetz

Title

Chief

Phone

(618) 476-1201

Specialties & licenses 1

Addresses

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": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770422400000",
    "number": "1780709139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600900547",
            "telephone_number": "618-476-1201",
            "fax_number": "336-791-0196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LAUREL ST",
            "city": "MILLSTADT",
            "state": "IL",
            "postal_code": "622601510",
            "telephone_number": "618-476-1201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLSTADT AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2026-02-07",
        "certification_date": "2026-02-07",
        "status": "A",
        "authorized_official_last_name": "GOETZ",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "618-476-1201"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "34",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah A Konya, FNP-BC
• Laboratory Corporation of America
• Hannah N Lane, PHARMD
• Matthew J. Kelly, DDS, LLC
• Beth Mayberry
• Millstadt CCSD 160
• Millstadt Family Chiropractic, PC
• Millstadt Pharmacy
• Lauren Elizabeth Milton, OTD, OTR/L
• Janelle Moore, P.T.

• Land Ambulance in Millstadt, IL
• Providers in Millstadt, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2026; 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.