County of Union

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

COUNTY OF UNION

Practice address

204 W Mississippi St
Jonesboro, IL 62952-0037

Phone

(618) 833-2871

Fax

(618) 833-6201

NPI assigned

Oct 5, 2006

Organization subpart

No

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

Authorized official

Name

Leigh A Burns

Title

County Treasurer

Phone

(618) 833-2871

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Union County Ambulance Service Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616371200000",
    "number": "1861588097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 W MISSISSIPPI ST",
            "address_2": "PO BOX 37",
            "city": "JONESBORO",
            "state": "IL",
            "postal_code": "629520037",
            "telephone_number": "618-833-2871",
            "fax_number": "618-833-6201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W MISSISSIPPI ST",
            "city": "JONESBORO",
            "state": "IL",
            "postal_code": "629520037",
            "telephone_number": "618-833-2871",
            "fax_number": "618-833-6201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF UNION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A",
        "authorized_official_last_name": "BURNS",
        "authorized_official_first_name": "LEIGH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "COUNTY TREASURER",
        "authorized_official_telephone_number": "618-833-2871"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "IL",
            "license": "55125",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590001833",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD IL",
            "identifier": "9170724",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Union County Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Union County Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Adams
• G&G Behavioral Health Consultants LLC
• Cody Hubble, DPT
• Tina M Jerolds
• Brady Jiter
• Jonesboro CC School Dist 43

• Land Ambulance in Jonesboro, IL
• Providers in Jonesboro, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; 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.

Verify at the official NPI Registry.