City of Waterloo

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

CITY OF WATERLOO

Practice address

425 E 3Rd St
Waterloo, IA 50703-3511

Phone

(319) 291-4460

Fax

(319) 291-4279

NPI assigned

Nov 3, 2006

Organization subpart

No

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

Authorized official

Name

Jason Hernandez

Title

Medical Supervisor

Phone

(319) 291-4279

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Waterloo Fire Rescue Doing business as

Medicare fee-for-service enrollment

Enrolled in IA

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": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1811076565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 E 3RD ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507033511",
            "telephone_number": "319-291-4279",
            "fax_number": "888-965-4620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 E 3RD ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507033511",
            "telephone_number": "319-291-4460",
            "fax_number": "319-291-4279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF WATERLOO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "MEDICAL SUPERVISOR",
        "authorized_official_telephone_number": "319-291-4279"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IA",
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0090217",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waterloo Fire Rescue",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Waterloo Fire Rescue",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christensen,Christensen & Freeseman,PC
• Tina Christian, HIS
• Hosung Chung, M.D.
• John R. Church, LMHC
• City Builders and Supplies
• Clark and Associates, Inc
• Jessica Nicole Clark, NP-C
• Kirby P Clark, M.D.
• Melissa Clark, ARNP
• Christopher Edmund Clayton, PHARMD

• Land Ambulance in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Land Ambulance in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.