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CANNON COUNTY AMBULANCE SERVICE
NPI 1710950704
Ambulance - Land Transport in Woodbury, TN

Active since February 09, 2006CLIA 44D0951789 · Waiver
104 ALEXANDER DR, WOODBURY, TN 37190(615) 563-5959(615) 563-6878 Get Directions Write a Review

NPPES record last updated: June 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 22, 2021, Dec 7, 2020, Mar 18, 2020 and 1 more (4 updates tracked since 2019).

About Cannon County Ambulance Service NPPES

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

CANNON COUNTY AMBULANCE SERVICE (NPI 1710950704) is a healthcare organization registered as a land transport in Woodbury, Tennessee and active in the NPI registry since February 2006. The organization holds a CLIA Waiver certificate valid through September 27, 2026 and lists Justin Harris, Director, as its authorized official.

NPPES Registry Identity

NPI1710950704
Entity TypeOrganization
Primary Taxonomy3416L0300X
Legal Business NameCANNON COUNTY AMBULANCE SERVICE
Location Address104 ALEXANDER DRWoodbury, TN 37190-5275
Mailing AddressPo Box 9150Paducah, KY 42002-9150 · (270) 744-9600 · Fax (270) 744-8642
Phone(615) 563-5959
Fax(615) 563-6878
Organization SubpartNo
Authorized OfficialJustin HarrisDirector · (615) 653-2655
Enumeration DateFebruary 9, 2006
Last NPPES UpdateJune 21, 20224 updates tracked since enumeration
NPPES CertifiedJune 21, 2022
✔ NPI 1710950704 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAmbulance · Land TransportTransportation Services
Taxonomy Code3416L0300X
Also ListedAmbulanceTaxonomy 341600000X
104 ALEXANDER DR, Woodbury, TN 37190
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Other Identifiers 4

Medicaid3525445TN
Other2007454TN · Tenn Care Non Emergency
Other4110424TN · Blue Cross Blue Shield
Other4110424TN · Tenn Care Emergency

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 44D0951789

Cannon County Ambulance Service · Woodbury, TN
Active · expires Sep 27, 2026
CLIA Number44D0951789
Laboratory TypeOther
Certificate Effective DateSeptember 28, 2024
Certificate Expiration DateSeptember 27, 2026
Laboratory DirectorRichard J. Cope
Laboratory Phone(615) 563-5959
Laboratory LocationCannon County Ambulance Service104 Alexander Drive, Woodbury, TN 37190
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 5

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.
7,246 services241 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.
261 services180 patients
Ambulance service, basic life support, non-emergency transport, (bls) A0428
Basic Life Support (BLS) non-emergency ambulance service provides safe transportation for patients who don't need immediate medical attention. It includes monitoring vital signs, ensuring comfort, and administering basic care during transport.
48 services41 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.
47 services45 patients
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) A0426
Ambulance Service, Advanced Life Support, Non-Emergency Transport, Level 1 (ALS 1) is a medical transportation service for patients who don't have an immediate life-threatening condition but require advanced medical monitoring or interventions during the journey.
25 services25 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 Cannon County Ambulance Service's NPI number?

The NPI number for Cannon County Ambulance Service is 1710950704. It was assigned to this organization in the NPPES registry on February 9, 2006.

Where is Cannon County Ambulance Service located?

Cannon County Ambulance Service is located at 104 Alexander Dr, Woodbury, TN 37190. The listed phone number is (615) 563-5959.

What is Cannon County Ambulance Service's specialty?

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

Does Cannon County Ambulance Service hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D0951789) is associated with this NPI, valid through September 27, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Cannon County Ambulance Service was last updated on June 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.