NPIMap

Organization Active NPI

Exira Fire & EMS Association Incorporated

  • Land Ambulance
  • Exira, IA
National Provider Identifier
1790213478
Registry record updated May 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
2050200 Issued in IA
Legal business name
EXIRA FIRE & EMS ASSOCIATION INCORPORATED
Practice address
2751 Highway 71
Exira, IA 50076-7648
Phone
(712) 249-1963
NPI assigned
May 25, 2017
Last updated
May 25, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2017

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

Authorized official

Name
Dillon Clemsen
Title
EMS President
Phone
(712) 249-1963

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 2050200 IA Primary

Addresses

Primary practice location

2751 Highway 71
Exira, IA 50076-7648

Mailing address

PO Box 641880
Omaha, NE 68164-7880
Phone (402) 991-7866

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170802003567 IA Part B Supplier - Ambulance Service Supplier 7315218781 Practice locations: Exira, IA

National Provider Directory

National Provider Directory

Locations

508 W Washington St
Exira, IA 50076
Phone (712) 249-1963

NPI Registry JSON

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

{
    "created_epoch": "1495670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495670400000",
    "number": "1790213478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 641880",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681647880",
            "telephone_number": "402-991-7866",
            "fax_number": "888-506-4589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 HIGHWAY 71",
            "city": "EXIRA",
            "state": "IA",
            "postal_code": "500767648",
            "telephone_number": "712-249-1963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXIRA FIRE & EMS ASSOCIATION INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-25",
        "last_updated": "2017-05-25",
        "status": "A",
        "authorized_official_last_name": "CLEMSEN",
        "authorized_official_first_name": "DILLON",
        "authorized_official_title_or_position": "EMS PRESIDENT",
        "authorized_official_telephone_number": "712-249-1963"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IA",
            "license": "2050200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Exira, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 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.

Verify at the official NPI Registry.