Ponca Hills Fire District

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

5110 Issued in NE

Legal business name

PONCA HILLS FIRE DISTRICT

Doing business as

Ponca Hills Volunteer Fire Dept

Practice address

12919 Ponca Rd
Omaha, NE 68112-1056

Phone

(402) 679-7558

NPI assigned

Aug 17, 2015

Last updated

Feb 7, 2023By 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

Michael Pallas

Title

President

Phone

(402) 453-6656

Specialties & licenses 1

Addresses

Other names 1

• Ponca Hills Volunteer Fire Dept Doing business as

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

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

{
    "created_epoch": "1439769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675728000000",
    "number": "1942676648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10802 FARNAM DR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681543237",
            "telephone_number": "877-218-4392",
            "fax_number": "877-343-0131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12919 PONCA RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681121056",
            "telephone_number": "402-679-7558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONCA HILLS FIRE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-17",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A",
        "authorized_official_last_name": "PALLAS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-453-6656"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NE",
            "license": "5110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ponca Hills Volunteer Fire Dept",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ponca Hills Volunteer Fire Dept",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Megan Polm
• Dmytro Poluliakh
• Justice Pomerleau-Joslyn
• Allen Pommier
• Shiva Pavan Ponamgi, M.D.
• Ponca Hills Volunteer Fire Department (Ponca Hills Volunteer Fire Dept.)
• Ponca Tribe of Nebraska
• Ponca Tribe of Nebraska (Fred LeRoy Health and Wellness Center)
• Ponca Tribe of Nebraska (Fred Leroy Health and Wellness Center)
• Ponca Tribe of Nebraska (Fred LeRoy Health & Wellness Center)

• Land Ambulance in Omaha, NE
• Providers in Omaha, NE by specialty
• Land Ambulance in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; 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.