Active NPI
City of Beaumont
- Land Ambulance
- Beaumont, TX
National Provider Identifier
1982695268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 123001
- Legal business name
- CITY OF BEAUMONT
- Practice address
- 801 Main St
Suite 110
Beaumont, TX 77701-3548 - Phone
- (409) 880-3772
- Fax
- (409) 880-3113
- NPI assigned
- Nov 4, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Todd Simoneaux
- Title
- Controller
- Phone
- (409) 785-4785
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 123001 | TX | Primary |
Addresses
Primary practice location
801 Main St
Suite 110
Beaumont, TX 77701-3548
Mailing address
PO Box 3827
Attn: Cash Management
Beaumont, TX 77704-3827
Phone (409) 880-3772
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000193501 | Medicaid | TX | |
| 590000931 | Other | TX | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101124000645 | TX | Part B Supplier - Ambulance Service Supplier | 0547456931 | Practice locations: Beaumont, TX |
National Provider Directory
National Provider Directory- Tax ID family
- City of Beaumont Public Health Department
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Public Health or Welfare Agency
- Beaumont, TX
- NPI 1255524070
Locations
801 Main St
Beaumont, TX 77701
Phone (409) 880-3128
801 Main St
Ste 110
Beaumont, TX 77701
Phone (409) 880-3772
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131062400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1278460800000",
"number": "1982695268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3827",
"address_2": "ATTN: CASH MANAGEMENT",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777043827",
"telephone_number": "409-880-3772",
"fax_number": "409-880-3113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 MAIN ST",
"address_2": "SUITE 110",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777013548",
"telephone_number": "409-880-3772",
"fax_number": "409-880-3113"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CITY OF BEAUMONT",
"organizational_subpart": "NO",
"enumeration_date": "2005-11-04",
"last_updated": "2010-07-07",
"status": "A",
"authorized_official_last_name": "SIMONEAUX",
"authorized_official_first_name": "TODD",
"authorized_official_title_or_position": "CONTROLLER",
"authorized_official_telephone_number": "409-785-4785",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "TX",
"license": "123001",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000193501",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "590000931",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beaumont, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2010; 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.