TILLMAN COUNTY OKLAHOMA EMERGENCY — NPI 1154432201 (Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance in FREDERICK, OK)

CMS-1500 Box 24J / 33a • NPI

1154432201

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

3416L0300X (CMS 59)

Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance

Box 32 Service Location & ZIP+4

300 E LUCILLE AVE, FREDERICK, OK, 73542-1422

✓ 9-Digit EDI 837 ZIP+4 (73542-1422)

Practice Phone & Referral Fax

(580) 335-5877

Fax: (580) 335-5512

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1154432201 (TILLMAN COUNTY OKLAHOMA EMERGENCY) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1154432201` (NPI-2 Organization / Facility)
Provider / Legal Name	TILLMAN COUNTY OKLAHOMA EMERGENCY
Plain-English Specialty	Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance NUCC Code: `3416L0300X` (Ambulance, Land Transport)
Certifying / Licensing Body	State EMS Authority / National Registry of Emergency Medical Technicians (NREMT)
Practice Location Address	300 E LUCILLE AVE, FREDERICK, OK, 73542-1422
Practice Telephone / Fax	Tel: (580) 335-5877 \| Fax: (580) 335-5512
Administrative Mailing Address	300 E LUCILLE AVE, FREDERICK, OK, 73542-1422
Enumeration & Last Sync	Enumerated: 2006-08-31 \| CMS Record Updated: 2022-01-19
Authorized Official	JACKIE JOHNSON (Office Manager)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

300 E LUCILLE AVE, FREDERICK, OK, 73542-1422

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Plain-English Taxonomy & CMS Crosswalk (3416L0300X)

What Does Taxonomy Code 3416L0300X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 3416L0300X translates to:
"Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 59 (Ambulance Service Provider)
Certifying / Accrediting Authority: State EMS Authority / National Registry of Emergency Medical Technicians (NREMT)
Clinical Scope: Emergency 911 pre-hospital medical response or medically supervised inter-hospital critical care transport.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (TILLMAN COUNTY OKLAHOMA EMERGENCY)

Typical CPT / Diagnostic Procedures:

Advanced Life Support (ALS) Pre-Hospital Cardiac Monitoring & Defibrillation
Pre-Hospital Trauma Immobilization, Airway Management & IV Access

Common Therapeutic Classes:

Pre-Hospital Epinephrine, Aspirin, Nitroglycerin, Naloxone & Albuterol

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`3416L0300X` — Ambulance, Land Transport Plain English: Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance	State: OK \| License: `EMS115` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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TILLMAN COUNTY OKLAHOMA EMERGENCY (NPI #1154432201)