1. Home
  2. Directory
  3. Mississippi
  4. Southaven
  5. Ambulance
  6. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

CITY OF SOUTHAVEN
NPI 1215033865
Ambulance - Land Transport in Southaven, MS

Active since September 14, 2006CLIA 25D2223617 · Waiver
8710 NORTHWEST DR, SOUTHAVEN, MS 38671(662) 393-7466(662) 393-7294 Get Directions Write a Review

NPPES record last updated: July 1, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 3, 2022, Aug 6, 2020 (2 updates tracked since 2020).

About City Of Southaven NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CITY OF SOUTHAVEN (NPI 1215033865), doing business as Southaven Fire Department Ambulance Service, is a healthcare organization registered as a land transport in Southaven, Mississippi and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through May 6, 2027 and lists Leroy Bledsoe, Fire Chief, as its authorized official.

NPPES Registry Identity

NPI1215033865
Entity TypeOrganization
Primary Taxonomy3416L0300X
Legal Business NameCITY OF SOUTHAVEN
Location Address8710 NORTHWEST DRSouthaven, MS 38671-2410
Mailing Address8710 Northwest DrSouthaven, MS 38671-2410 · (662) 393-7466 · Fax (270) 744-8642
Phone(662) 393-7466
Fax(662) 393-7294
Organization SubpartNo
Authorized OfficialLeroy BledsoeFire Chief · (662) 280-2489
Enumeration DateSeptember 14, 2006
Last NPPES UpdateJuly 1, 20262 updates tracked since enumeration
NPPES CertifiedJuly 1, 2026
✔ NPI 1215033865 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAmbulance · Land TransportTransportation Services
Taxonomy Code3416L0300X
License✔ Licensed in MS · 128
8710 NORTHWEST DR, Southaven, MS 38671
Open in Google Maps ↗

Other Names 1

Doing Business AsSouthaven Fire Department Ambulance Service

Other Identifiers 2

Medicaid07774861MS
Other223862186MS · Bcbs

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 25D2223617

Southaven Fire Department Ambulance Service · Southaven, MS
Active · expires May 6, 2027
CLIA Number25D2223617
Laboratory TypeAmbulance
Certificate Effective DateMay 7, 2025
Certificate Expiration DateMay 6, 2027
Laboratory DirectorSamantha N. Watts
Laboratory Phone(662) 393-7466
Laboratory LocationSouthaven Fire Department Ambulance Service8710 Northwest Dr, Southaven, MS 38671
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Ground mileage, per statute mile A0425
Ground mileage per statute mile is a method of calculating the cost of transportation for medical services. It is used when a patient needs to be transported by ground ambulance. The cost is calculated per mile, from the pick-up location to the medical facility.
5,054 services865 patients
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) A0427
Ambulance Service, Advanced Life Support, Level 1 (ALS 1 - Emergency) is a critical care transport service for emergency situations. It includes a team of healthcare professionals equipped with advanced skills and tools to manage life-threatening conditions during transport.
1,020 services726 patients
Ambulance service, basic life support, emergency transport (bls-emergency) A0429
Ambulance service with basic life support (BLS-Emergency) provides immediate transport for patients in critical situations. Medical professionals on board deliver essential care like CPR, wound dressing, and oxygen therapy to stabilize patients during the journey.
285 services223 patients
Advanced life support, level 2 (als 2) A0433
Advanced Life Support Level 2 (ALS 2) is a medical service provided during emergencies. It involves advanced procedures like defibrillation, medication administration or endotracheal intubation by trained professionals to stabilize critical patients.
15 services15 patients

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is City Of Southaven's NPI number?

The NPI number for City Of Southaven is 1215033865. It was assigned to this organization in the NPPES registry on September 14, 2006. The provider is doing business as Southaven Fire Department Ambulance Service.

Where is City Of Southaven located?

City Of Southaven is located at 8710 Northwest Dr, Southaven, MS 38671. The listed phone number is (662) 393-7466.

What is City Of Southaven's specialty?

The primary specialty registered for this NPI is Ambulance, specializing in Land Transport, with taxonomy code 3416L0300X.

Does City Of Southaven hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D2223617) is associated with this NPI, valid through May 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for City Of Southaven was last updated on July 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 44 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.