Active NPI
Wayne County Ambulance Service
- Ambulance
- Fairfield, IL
National Provider Identifier
1821067737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulance
- Legal business name
- WAYNE COUNTY AMBULANCE SERVICE
- Practice address
- 501 SW 7TH St
Fairfield, IL 62837-1470 - Phone
- (618) 842-7346
- Fax
- (618) 847-4019
- NPI assigned
- Mar 14, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. John C Higham
- Title
- Director
- Phone
- (618) 842-7346
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | Primary |
Addresses
Primary practice location
501 SW 7TH St
Fairfield, IL 62837-1470
Mailing address
501 SW 7TH St
PO Box 92
Fairfield, IL 62837-1470
Phone (618) 842-7346
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101004001142 | IL | Part B Supplier - Ambulance Service Supplier | 1759573173 | Practice locations: Fairfield, IL |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D2238718 | Wayne County Ambulance Service | Certificate of waiver | Oct 5, 2027 |
National Provider Directory
National Provider DirectoryLocations
501 SW 7th St
Fairfield, IL 62837
Phone (618) 842-7346
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142294400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1297123200000",
"number": "1821067737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 SW 7TH ST",
"address_2": "PO BOX 92",
"city": "FAIRFIELD",
"state": "IL",
"postal_code": "628371470",
"telephone_number": "618-842-7346",
"fax_number": "618-847-4019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 SW 7TH ST",
"city": "FAIRFIELD",
"state": "IL",
"postal_code": "628371470",
"telephone_number": "618-842-7346",
"fax_number": "618-847-4019"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WAYNE COUNTY AMBULANCE SERVICE",
"organizational_subpart": "NO",
"enumeration_date": "2006-03-14",
"last_updated": "2011-02-08",
"status": "A",
"authorized_official_last_name": "HIGHAM",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "618-842-7346",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "341600000X",
"taxonomy_group": "",
"desc": "Ambulance",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fairfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.