NPIMap

Organization Active NPI

County of Lincoln

  • Land Ambulance
  • Lincoln, KS
National Provider Identifier
1851341978
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
1080 Issued in KS
Legal business name
COUNTY OF LINCOLN
Practice address
102 N 6TH St
Lincoln, KS 67455-1928
Phone
(785) 524-5216
NPI assigned
May 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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

Authorized official

Name
Derek Walter
Title
Ambulance Director
Phone
(785) 524-4757

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 1080 KS Primary

Addresses

Primary practice location

102 N 6TH St
Lincoln, KS 67455-1928

Mailing address

216 E Lincoln Ave
Lincoln, KS 67455-2058
Phone (785) 524-4757

Other identifiers 2

IdentifierTypeStateIssuer
399220OtherKS1ST GUARD HEALTH
100243410AMedicaidKS

Other names 1

  • Lincoln County Ambulance Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050610000273 KS Part B Supplier - Ambulance Service Supplier 5395653414 Practice locations: Lincoln, KS

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D2093630Lincoln County Ambulance Service102 N 6TH St, Lincoln, KS 67455Certificate of waiverMar 30, 2027

National Provider Directory

National Provider Directory
Tax ID family
County of Lincoln3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 4

Organizations listed as members of this organization in the National Provider Directory.

Locations

216 E Lincoln Ave
Lincoln, KS 67455
Phone (785) 524-4757

102 N 6th St
Lincoln, KS 67455
Phone (785) 524-5216

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lincoln County HospitalLincoln, KS, CCN 171360 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Lincoln County HospitalLincoln, KS, CCN 17Z360 Hospital 5% Or Greater Direct Ownership Interest (100%) Aug 1, 2003
Lincoln Medical ClinicLincoln, KS, CCN 173405 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1976

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597881600000",
    "number": "1851341978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 E LINCOLN AVE",
            "city": "LINCOLN",
            "state": "KS",
            "postal_code": "674552058",
            "telephone_number": "785-524-4757",
            "fax_number": "785-524-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 N 6TH ST",
            "city": "LINCOLN",
            "state": "KS",
            "postal_code": "674551928",
            "telephone_number": "785-524-5216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF LINCOLN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A",
        "authorized_official_last_name": "WALTER",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "AMBULANCE DIRECTOR",
        "authorized_official_telephone_number": "785-524-4757"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "KS",
            "license": "1080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1ST GUARD HEALTH",
            "identifier": "399220",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100243410A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lincoln County Ambulance",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lincoln County Ambulance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincoln, KS

Sources for this page

Verify at the official NPI Registry.