Active NPI
Park River Volunteer Ambulance
- Land Ambulance
- Park River, ND
National Provider Identifier
1861582884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 101
- Legal business name
- PARK RIVER VOLUNTEER AMBULANCE
- Practice address
- 115 Vivian Street
Park River, ND 58270-0106 - Phone
- (701) 284-6280
- Fax
- (701) 284-6228
- NPI assigned
- Oct 13, 2006
- Last updated
- Oct 11, 2007
- 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
- Ms. Cindy G Staven
- Title
- Treasurer
- Phone
- (701) 284-6675
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 101 | ND | Primary |
Addresses
Primary practice location
115 Vivian Street
Park River, ND 58270-0106
Mailing address
PO Box 106
Park River, ND 58270-0106
Phone (701) 284-6280
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 050464 | Medicaid | ND | |
| 7142 | Other | ND | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100116000382 | ND | Part B Supplier - Ambulance Service Supplier | 5193867935 | Practice locations: Park River, ND |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1192060800000",
"number": "1861582884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 106",
"city": "PARK RIVER",
"state": "ND",
"postal_code": "582700106",
"telephone_number": "701-284-6280",
"fax_number": "701-284-6228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 VIVIAN STREET",
"city": "PARK RIVER",
"state": "ND",
"postal_code": "582700106",
"telephone_number": "701-284-6280",
"fax_number": "701-284-6228"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PARK RIVER VOLUNTEER AMBULANCE",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-13",
"last_updated": "2007-10-11",
"status": "A",
"authorized_official_last_name": "STAVEN",
"authorized_official_first_name": "CINDY",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "TREASURER",
"authorized_official_telephone_number": "701-284-6675",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "ND",
"license": "101",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "050464",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "7142",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Park River, ND
- P R Health Corporation (First Care RHC)
- P R Health Corporation (First Care Pharmacy)
- P R Health Corporation (First Care Swing Bed)
- P R Health Corporation (First Care Health Center)
- Park River Dental, PC (Park River Dental)
- Kristi Agnes Parrish
- Benjamin Phelps, PT, DPT
- Physician Management Services of North Dakota, LLC
- Kara Ruhland, PHARM D
- Alexandria Leigh Skyrud, FNP-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.