County of Wise

Primary specialty

AmbulanceTaxonomy code 341600000X

License

249008 Issued in TX

Legal business name

COUNTY OF WISE

Practice address

1101 Rose Ave.
Decatur, TX 76234

Phone

(940) 627-2002

Fax

(940) 627-7521

NPI assigned

Jul 29, 2006

Organization subpart

No

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

Authorized official

Name

Randall Preuninger

Title

EMS Administrator

Phone

(940) 627-2002

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Wise County EMS Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

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

CLIA laboratory certificates

Tax ID family

County of Wise2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Wise County Emergency Medical Services

  • Land Ambulance
  • Decatur, TX
  • NPI 1649273376
  NPD tax ID

Locations

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713916800000",
    "number": "1891700753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 W ROSE AVE",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762343304",
            "telephone_number": "940-627-2002",
            "fax_number": "940-627-7521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 ROSE AVE.",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "76234",
            "telephone_number": "940-627-2002",
            "fax_number": "940-627-7521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF WISE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A",
        "authorized_official_last_name": "PREUNINGER",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "EMS ADMINISTRATOR",
        "authorized_official_telephone_number": "940-627-2002"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "TX",
            "license": "249008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF TEXAS",
            "identifier": "514948",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "088232601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590005964",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wise County EMS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wise County EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Karen J Contreras, PMHNP
• Larry J Cooper, MD
• David Gatti Corless, D.M.D
• Dee Cornell, PT ATC
• Cornerstone Caregiving West LLC
• Donna Carole Covey, DNP, FNP, AGACNP
• Megan Covington, PT
• Tiffany Michelle Cox, RN
• Trinika Latrice Cox, MOT/OTR
• William Cross

• All providers in Decatur, TX
• Ambulance in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.