Lifeteam Indiana

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

0922 Issued in IN

Legal business name

LIFETEAM INDIANA

Practice address

28 W Church St
Cambridge Cty, IN 47327-1615

Phone

(765) 478-3800

Fax

(765) 478-3880

NPI assigned

Jan 23, 2006

Last updated

Apr 20, 2008By 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

Mrs. Brieann Rich, NREMT I

Title

Director of Operations

Phone

(765) 478-3800

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Lifeteam Emergency Medical Services Other name

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1841260940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 4TH AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257011407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 W CHURCH ST",
            "city": "CAMBRIDGE CTY",
            "state": "IN",
            "postal_code": "473271615",
            "telephone_number": "765-478-3800",
            "fax_number": "765-478-3880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETEAM INDIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-23",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "RICH",
        "authorized_official_first_name": "BRIEANN",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "765-478-3800",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NREMT I"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "IN",
            "license": "0922",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IN",
            "license": "0922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000387875",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00429801",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2728016",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifeteam Emergency Medical Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.