City of Jeffers

Primary specialty

AmbulanceTaxonomy code 341600000X

License

8203706 Issued in MN

Legal business name

CITY OF JEFFERS

Practice address

106 S Deaver Ave
Jeffers, MN 56145

Phone

(507) 628-4242

Fax

(507) 628-4210

NPI assigned

May 29, 2007

Last updated

Jul 9, 2008By 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

Mrs. Morgen M Pederson, EMT

Title

Director

Phone

(507) 628-5533

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Jeffers Ambulance Service Other name

Locations

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215561600000",
    "number": "1992906960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 237",
            "city": "JEFFERS",
            "state": "MN",
            "postal_code": "56145",
            "telephone_number": "507-628-4242",
            "fax_number": "507-628-4210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 S DEAVER AVE",
            "city": "JEFFERS",
            "state": "MN",
            "postal_code": "56145",
            "telephone_number": "507-628-4242",
            "fax_number": "507-628-4210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF JEFFERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2008-07-09",
        "status": "A",
        "authorized_official_last_name": "PEDERSON",
        "authorized_official_first_name": "MORGEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "507-628-5533",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "EMT"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "MN",
            "license": "8203706",
            "primary": true
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "713768100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "43139JE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jeffers Ambulance Service",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; 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.