City of Sudan

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

140007 Issued in TX

Legal business name

CITY OF SUDAN

Practice address

101 Hornet Drive
Sudan, TX 79371

Phone

(806) 227-2113

Fax

(806) 227-2114

NPI assigned

Dec 22, 2005

Organization subpart

No

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

Authorized official

Name

Patricia Hill, EMT I

Title

Emt-I Billing Coordintor

Phone

(806) 638-9987

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sudan Fire Dept EMS Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447977600000",
    "number": "1801873609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 491",
            "city": "SUDAN",
            "state": "TX",
            "postal_code": "793710491",
            "telephone_number": "806-227-2113",
            "fax_number": "806-227-2114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HORNET DRIVE",
            "city": "SUDAN",
            "state": "TX",
            "postal_code": "79371",
            "telephone_number": "806-227-2113",
            "fax_number": "806-227-2114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF SUDAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-22",
        "last_updated": "2015-11-20",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "EMT-I BILLING COORDINTOR",
        "authorized_official_telephone_number": "806-638-9987",
        "authorized_official_credential": "EMT I"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "TX",
            "license": "140007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000643901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sudan Fire Dept EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lisa M Allen, PA-C
• Erin Jo Gonzales, FNP-C
• Kaylie Long, LMT
• Bryleigh Schovajsa
• Sudan Isd
• Sudan Medical Clinic, LLC

• All providers in Sudan, TX
• Land Ambulance in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2015; 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.