South Scott County Ambulance

Primary specialty

AmbulanceTaxonomy code 341600000X

Legal business name

SOUTH SCOTT COUNTY AMBULANCE

Practice address

202 Lillian Dr
Sikeston, MO 63801-2236

Phone

(573) 472-4161

NPI assigned

Jun 11, 2007

Organization subpart

No

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

Authorized official

Name

Kenneth Dicus

Title

EMS Director

Phone

(573) 472-4161

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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": "1181520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681776000000",
    "number": "1780888255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 LILLIAN DR",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638012236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 LILLIAN DR",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638012236",
            "telephone_number": "573-472-4161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SCOTT COUNTY AMBULANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-11",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A",
        "authorized_official_last_name": "DICUS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "EMS DIRECTOR",
        "authorized_official_telephone_number": "573-472-4161"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Smith Street Medical Clinic
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• Rebecca Ann Snyder, PTA
• Kendra Sokolowski, PTA
• Southeast Health Center of Stoddard County LLC
• Southeast Missouri Health Network
• Southeast Missouri Health Network
• Southeast Missouri Health Network
• Southeast Missouri Health Network

• All providers in Sikeston, MO
• Ambulance in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.