Washington County Ambulance District

Primary specialty

ParamedicTaxonomy code 146L00000X

License

12622087 Issued in MO

Legal business name

WASHINGTON COUNTY AMBULANCE DISTRICT

Practice address

6900 Bill Gum Business Blvd
Mineral Point, MO 63660-9253

Phone

(573) 438-3635

Fax

(573) 438-3665

NPI assigned

Apr 12, 2007

Last updated

Jun 16, 2021By 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. Justin Duncan

Title

Adminstrator

Phone

(573) 438-3635

Specialties & licenses 1

Addresses

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anthony J Mingo, EMT-CP, CHW-C

  • Paramedic
  • Mineral Point, MO
  • NPI 1144025107
  NPD

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623801600000",
    "number": "1790909828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 BILL GUM BUSINESS BLVD",
            "city": "POTOSI",
            "state": "MO",
            "postal_code": "636641877",
            "telephone_number": "573-438-3635",
            "fax_number": "573-438-3665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 BILL GUM BUSINESS BLVD",
            "city": "MINERAL POINT",
            "state": "MO",
            "postal_code": "636609253",
            "telephone_number": "573-438-3635",
            "fax_number": "573-438-3665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON COUNTY AMBULANCE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2021-06-16",
        "certification_date": "2020-08-17",
        "status": "A",
        "authorized_official_last_name": "DUNCAN",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "ADMINSTRATOR",
        "authorized_official_telephone_number": "573-438-3635",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "146L00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Paramedic",
            "state": "MO",
            "license": "12622087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hillside Living Center LLC
• Anthony J Mingo, EMT-CP, CHW-C
• South Haven Residential Care Center, LLC
• South Haven Residential Care LLC
• Transition-Ready Services

• Paramedic in Mineral Point, MO
• Providers in Mineral Point, MO by specialty
• Paramedic in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; 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.