Organization Active NPI

Cape County Private Ambulance Service, Inc.

  • Ambulance
  • Cape Girardeau, MO
National Provider Identifier
1942357090
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
031003 Issued in MO
Legal business name
CAPE COUNTY PRIVATE AMBULANCE SERVICE, INC.
Practice address
1458 N Kingshighway St
Cape Girardeau, MO 63701-2117
Phone
(573) 335-2191
Fax
(573) 335-8891
NPI assigned
Jan 4, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. John J Russell, M.D.NPI 1124098728
Title
President
Phone
(573) 335-2191

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 031003 MO Primary

Addresses

Primary practice location

1458 N Kingshighway St
Cape Girardeau, MO 63701-2117

Mailing address

1458 N Kingshighway St
Cape Girardeau, MO 63701-2117
Phone (573) 335-2191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091230000054 MO Part B Supplier - Ambulance Service Supplier 4880734656 Practice locations: Cape Girardeau, MO

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D0686162Cape County Private Ambulance Serv Inc1458 N Kingshighway, Cape Girardeau, MO 63701Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

1458 N Kingshighway St
Cpe Girardeau, MO 63701
Phone (573) 335-2191

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942357090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1458 N KINGSHIGHWAY ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637012117",
            "telephone_number": "573-335-2191",
            "fax_number": "573-335-8891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1458 N KINGSHIGHWAY ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637012117",
            "telephone_number": "573-335-2191",
            "fax_number": "573-335-8891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPE COUNTY PRIVATE AMBULANCE SERVICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-335-2191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "MO",
            "license": "031003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.