Active NPI
Divide County Ambulance District
- Land Ambulance
- Crosby, ND
National Provider Identifier
1902012404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 027
- Legal business name
- DIVIDE COUNTY AMBULANCE DISTRICT
- Practice address
- 702 1St St SW
Crosby, ND 58730-3329 - Phone
- (701) 713-6038
- NPI assigned
- May 14, 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
- Timothy D Swanson
- Title
- EMS Operations Manager
- Phone
- (701) 713-6038
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 027 | ND | Primary |
Addresses
Primary practice location
702 1St St SW
Crosby, ND 58730-3329
Mailing address
107 West Central Ave
PO Box 31
Crosby, ND 58730-0031
Phone (701) 965-6321
Other practice location 1
107 West Central Ave
Crosby, ND 58730-0031
Phone (701) 965-4043
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7105 | Other | ND | BLUE CROSS BLUE SHIELD |
| 50290 | Medicaid | ND |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100818000266 | ND | Part B Supplier - Ambulance Service Supplier | 9830223403 | Practice locations: Crosby, ND |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1601856000000",
"number": "1902012404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 WEST CENTRAL AVE",
"address_2": "PO BOX 31",
"city": "CROSBY",
"state": "ND",
"postal_code": "587300031",
"telephone_number": "701-965-6321",
"fax_number": "701-965-4444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "702 1ST ST SW",
"city": "CROSBY",
"state": "ND",
"postal_code": "587303329",
"telephone_number": "701-713-6038"
}
],
"practiceLocations": [
{
"address_1": "107 WEST CENTRAL AVE",
"address_purpose": "LOCATION",
"city": "CROSBY",
"state": "ND",
"postal_code": "587300031",
"country_code": "US",
"telephone_number": "701-965-4043",
"fax_number": "701-965-4444",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "DIVIDE COUNTY AMBULANCE DISTRICT",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-14",
"last_updated": "2020-10-05",
"certification_date": "2020-10-05",
"status": "A",
"authorized_official_last_name": "SWANSON",
"authorized_official_first_name": "TIMOTHY",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "EMS OPERATIONS MANAGER",
"authorized_official_telephone_number": "701-713-6038"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "ND",
"license": "027",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "7105",
"state": "ND"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "50290",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Crosby, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; 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.