Provider Type Icon

PRAIRIE BAND POTAWATOMI NATION NPI 1174577738


NPI Information

NPI: 1174577738
Provider Name: PRAIRIE BAND POTAWATOMI NATION

Doing Business As: POTAWATOMI TRIBAL FIRE DEPARTMENT

Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

CLIA Number: 17D0980594

Address:
15468 K RD
MAYETTA, KS
ZIP 66509
Phone: (785) 966-2164
Get Directions

PRAIRIE BAND POTAWATOMI NATION is a land transport ambulance in Mayetta, KS. PRAIRIE BAND POTAWATOMI NATION NPI is 1174577738. The provider is registered as an organization entity type.
The provider Is Doing Business As Potawatomi Tribal Fire Department.

The provider's business location address is:

15468 K RD
MAYETTA, KS
ZIP 66509-093
Phone: (785) 966-2164

The provider's authorized official is Liana Onnen .
The authorized official title is Tribal Chairperson and has the following contact phone number (785) 966-4007.

The CLIA number assigned to this NPI record is 17D0980594 - ambulance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/19/2006 and was last updated on 7/20/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13416L0300XAmbulanceLand Transport1555KANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1112020MEDICARE ID-TYPE UNSPECIFIEDKANSAS
2112020OTHERKANSASBLUE CROSS/BLUE SHIELD
3100416330AMEDICAIDKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.