City of Collinsville

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

33 Issued in OK

Legal business name

CITY OF COLLINSVILLE

Doing business as

City of Collinsville EMS

Practice address

1214 W Main St
Collinsville, OK 74021-3115

Phone

(918) 371-1031

Fax

(918) 371-1030

NPI assigned

Jan 22, 2007

Last updated

May 6, 2009By 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

Jilian W Miller

Title

Interim EMS Director

Phone

(918) 371-1031

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• City of Collinsville EMS Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241568000000",
    "number": "1871647750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1214 W MAIN ST",
            "city": "COLLINSVILLE",
            "state": "OK",
            "postal_code": "740213115",
            "telephone_number": "918-371-1031",
            "fax_number": "918-371-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1214 W MAIN ST",
            "city": "COLLINSVILLE",
            "state": "OK",
            "postal_code": "740213115",
            "telephone_number": "918-371-1031",
            "fax_number": "918-371-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF COLLINSVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2009-05-06",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "JILIAN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "INTERIM EMS DIRECTOR",
        "authorized_official_telephone_number": "918-371-1031"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OK",
            "license": "33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100819700A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "City of Collinsville EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelsey Brown
• Jan Byerly, APRN
• Gary Cannon, D.O.
• Mary Lovelady Carter, MS, RD, LD, CDE
• Andrea J Caygill, CSFA
• City of Sapulpa (North County Senior Living)
• Sherri Laverne Clark, DPH
• Emily Cline
• Kelly Faye Coffin, RN
• Collinsville Family Clinic, Inc.

• Land Ambulance in Collinsville, OK
• Providers in Collinsville, OK by specialty
• Land Ambulance in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2009; 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.