Perry County Ambulance Authority, Inc.

Key facts

NPI: 1801929005
Entity type: Organization (NPI type 2)
Primary specialty: Land Ambulance 3416L0300X
Legal business name: PERRY COUNTY AMBULANCE AUTHORITY, INC.
Practice address: 22 Terrance View Dr.
Hazard, KY 41701
Phone: (606) 439-4776
Fax: (606) 439-5193
NPI assigned: Mar 14, 2007
Organization subpart: No

Authorized official

Name: Elizabeth J Stacy
Title: EMS Director
Phone: (606) 439-4776

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Anderson County Treasurer Land Ambulance · Lawrenceburg, KY · NPI 1295732477

NPD member Member Of

Medicare participation

Medicare fee-for-service enrollment: Enrolled in KY

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20031222000205	KY	Part B Supplier - Ambulance Service Supplier	5799683355	Practice locations: Hazard, KY; Hindman, KY

National Provider Directory

Locations

22 Terrace View Dr
Hazard, KY 41701

2264 N Main St
Hazard, KY 41701
Phone (606) 436-6554

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Land Ambulance	3416L0300X			Yes

Addresses

Primary practice location

22 Terrance View Dr.
Hazard, KY 41701

Mailing address

22 Terrance View Dr.
Hazard, KY 41701
Phone (606) 439-4776

Other practice location 1

3068 Highway 160 S Ste 2
Hindman, KY 41822-9056
Phone (606) 439-4776

Other identifiers

Identifier	Type	State	Issuer
55097034	Medicaid	KY
407540578	Other	KY	RAILROAD MEDICARE
0832278	Other	KY	UMWA
56004633	Medicaid	KY

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 23, 2024.

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716422400000",
    "number": "1801929005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 TERRANCE VIEW DR.",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "41701",
            "telephone_number": "606-439-4776",
            "fax_number": "606-439-4776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 TERRANCE VIEW DR.",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "41701",
            "telephone_number": "606-439-4776",
            "fax_number": "606-439-5193"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3068 Highway 160 S Ste 2",
            "address_purpose": "LOCATION",
            "city": "Hindman",
            "state": "KY",
            "postal_code": "418229056",
            "country_code": "US",
            "telephone_number": "606-439-4776",
            "fax_number": "606-439-5193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PERRY COUNTY AMBULANCE AUTHORITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-17",
        "status": "A",
        "authorized_official_last_name": "STACY",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EMS DIRECTOR",
        "authorized_official_telephone_number": "606-439-4776"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55097034",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "407540578",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "0832278",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "56004633",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazard, KY

All providers in Hazard, KY · Land Ambulance in Kentucky

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 23, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider 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.