Sullivan County Ambulance District

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

211001 Issued in MO

Legal business name

SULLIVAN COUNTY AMBULANCE DISTRICT

Practice address

113 S Leewood Dr
# 1
Milan, MO 63556-1100

Phone

(660) 265-3553

Fax

(660) 265-3651

NPI assigned

Jun 21, 2005

Last updated

Jul 13, 2011By 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. Matthew Ryan Keuhn

Title

Administrator

Phone

(660) 265-3553

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310515200000",
    "number": "1790781136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 S LEEWOOD DR",
            "address_2": "# 1",
            "city": "MILAN",
            "state": "MO",
            "postal_code": "635561100",
            "telephone_number": "660-265-3553",
            "fax_number": "660-265-3651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 S LEEWOOD DR",
            "address_2": "# 1",
            "city": "MILAN",
            "state": "MO",
            "postal_code": "635561100",
            "telephone_number": "660-265-3553",
            "fax_number": "660-265-3651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SULLIVAN COUNTY AMBULANCE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-21",
        "last_updated": "2011-07-13",
        "status": "A",
        "authorized_official_last_name": "KEUHN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "660-265-3553",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MO",
            "license": "211001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800324808",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• School Dist 2 Milan
• Gary Ryan Snelling, PTA
• Katelin Rae Spratt I
• Kailee Stephenson, DC
• Stover's Residential Care Facility
• Sullivan County Health Department
• Sullivan County Memorial Hospital
• Sullivan County Memorial Hospital
• Sullivan County Memorial Hospital
• Sullivan County Memorial Hospital

• Land Ambulance in Milan, MO
• Providers in Milan, MO by specialty
• Land Ambulance in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2011; 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.