Village of Greenup

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

66765 Issued in IL

Legal business name

VILLAGE OF GREENUP

Practice address

115E Cumberland Street
Greeenup, IL 62428-0246

Phone

(217) 923-3401

Fax

(217) 923-3424

NPI assigned

Mar 6, 2007

Last updated

Oct 11, 2021By 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

Jill Kimble

Title

Village Clerk

Phone

(217) 923-3401

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Greenup Community Ambulance Service Other name

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633910400000",
    "number": "1942330386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 246",
            "address_2": "115 E CUMBERLAND STREET",
            "city": "GREENUP",
            "state": "IL",
            "postal_code": "624280246",
            "telephone_number": "217-923-3401",
            "fax_number": "217-923-3424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115E CUMBERLAND STREET",
            "city": "GREEENUP",
            "state": "IL",
            "postal_code": "624280246",
            "telephone_number": "217-923-3401",
            "fax_number": "217-923-3424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF GREENUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A",
        "authorized_official_last_name": "KIMBLE",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "VILLAGE CLERK",
        "authorized_official_telephone_number": "217-923-3401"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "66765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01821622",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greenup Community Ambulance Service",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Greenup Community Ambulance Service",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.