Jefferson TWP Elkhart Co

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

0181 Issued in IN

Legal business name

JEFFERSON TWP ELKHART CO

Practice address

58518 State Road 15
Goshen, IN 46528-8673

Phone

(574) 533-0261

NPI assigned

Aug 30, 2006

Organization subpart

No

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

Authorized official

Name

Martin L Lowe

Title

EMS Director

Phone

(574) 533-0261

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Jefferson Township Ambulance Service Other name

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368144000000",
    "number": "1922117233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 727",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465150727",
            "telephone_number": "574-293-3030",
            "fax_number": "574-294-1345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58518 STATE ROAD 15",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465288673",
            "telephone_number": "574-533-0261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON TWP ELKHART CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-05-10",
        "status": "A",
        "authorized_official_last_name": "LOWE",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EMS DIRECTOR",
        "authorized_official_telephone_number": "574-533-0261"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IN",
            "license": "0181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC PTAN",
            "identifier": "590000434",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200364730A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000211128",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jefferson Township Ambulance Service",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Land Ambulance in Goshen, IN
• Providers in Goshen, IN by specialty
• Land Ambulance in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2013; 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.