SOUTH PARK AMBULANCE DISTRICT NPI 1811091051

NPI Information

  • NPI: 1811091051
  • Provider Name: SOUTH PARK AMBULANCE DISTRICT
  • Classification: Ambulance - 3416L0300X
  • Specialization: Land Transport
  • Entity Type: Organization
  • CLIA Number: 06D0698408
  • Address: 911 CASTELLO AVENUE
    FAIRPLAY, CO
    ZIP 80440
  • Phone: (719) 836-2055

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NPI Details

SOUTH PARK AMBULANCE DISTRICT is a land transport ambulance in Fairplay, CO. SOUTH PARK AMBULANCE DISTRICT NPI is 1811091051. The provider is registered as an organization entity type.

The provider's business location address is:

911 CASTELLO AVENUE
FAIRPLAY, CO
ZIP 80440
Phone: (719) 836-2055

The provider's authorized official is Lissa Mattson .
The authorized official title is Chief Administrative Officer and has the following contact phone number (719) 836-2055.

The CLIA number assigned to this NPI record is 06D0698408 - ambulance with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Ground mileage, per statute mile (HCPCS:A0425)
  • Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) (HCPCS:A0427)
  • Ambulance service, basic life support, emergency transport (bls-emergency) (HCPCS:A0429)

The enumeration date for this NPI number is 9/8/2006 and was last updated on 8/22/2020.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13416L0300XAmbulanceLand TransportYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
106000442MEDICAIDCOLORADO

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: 11/21/2025

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