Organization Active NPI

Caddo Fire District No 1

  • Land Ambulance
  • Shreveport, LA
National Provider Identifier
1972657799
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
9110084 Issued in LA
Legal business name
CADDO FIRE DISTRICT NO 1
Practice address
7058 Old Mooringsport Rd
Shreveport, LA 71107-9231
Phone
(318) 929-3575
Fax
(318) 929-2345
NPI assigned
Jan 22, 2007
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
Mr. Dan Cotten
Title
Fire Chief
Phone
(318) 929-3575

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 9110084 LA Primary

Addresses

Primary practice location

7058 Old Mooringsport Rd
Shreveport, LA 71107-9231

Mailing address

7058 Old Mooringsport Rd
Shreveport, LA 71107-9231
Phone (318) 929-3575

Other identifiers 1

IdentifierTypeStateIssuer
1471585MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040901000108 LA Part B Supplier - Ambulance Service Supplier 4880669944 Practice locations: Shreveport, LA

National Provider Directory

National Provider Directory

Locations

7058 Old Mooringsport Rd
Shreveport, LA 71107
Phone (318) 929-2345

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972657799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7058 OLD MOORINGSPORT RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711079231",
            "telephone_number": "318-929-3575",
            "fax_number": "318-929-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7058 OLD MOORINGSPORT RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711079231",
            "telephone_number": "318-929-3575",
            "fax_number": "318-929-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CADDO FIRE DISTRICT NO 1",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COTTEN",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "318-929-3575",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "LA",
            "license": "9110084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1471585",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.