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SOUTH PARK AMBULANCE DISTRICT
NPI 1811091051
Ambulance - Land Transport in Fairplay, CO

Active since September 08, 2006CLIA 06D0698408 · Waiver
911 CASTELLO AVENUE, FAIRPLAY, CO 80440(719) 836-2055 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About South Park Ambulance District NPPES

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

SOUTH PARK AMBULANCE DISTRICT (NPI 1811091051) is a healthcare organization registered as a land transport in Fairplay, Colorado and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Lissa Mattson, Chief Administrative Officer, as its authorized official.

NPPES Registry Identity

NPI1811091051
Entity TypeOrganization
Primary Taxonomy3416L0300X
Legal Business NameSOUTH PARK AMBULANCE DISTRICT
Location Address911 CASTELLO AVENUEFairplay, CO 80440
Mailing Address911 Castello AvenueFairplay, CO 80440
Phone(719) 836-2055
Organization SubpartNo
Authorized OfficialLissa MattsonChief Administrative Officer · (719) 836-2055
Enumeration DateSeptember 8, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1811091051 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAmbulance · Land TransportTransportation Services
Taxonomy Code3416L0300X
911 CASTELLO AVENUE, Fairplay, CO 80440
Open in Google Maps ↗

Other Identifiers 1

Medicaid06000442CO

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 06D0698408

South Park Ambulance District · Fairplay, CO
Active · expires Aug 31, 2026
CLIA Number06D0698408
Laboratory TypeAmbulance
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorPaul C. Mattson
Laboratory Phone(719) 836-2771
Laboratory LocationSouth Park Ambulance District911 Castello PO Box 417, Fairplay, CO 80440
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 3

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.
2,894 services52 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.
46 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.
13 services11 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 South Park Ambulance District's NPI number?

The NPI number for South Park Ambulance District is 1811091051. It was assigned to this organization in the NPPES registry on September 8, 2006.

Where is South Park Ambulance District located?

South Park Ambulance District is located at 911 Castello Avenue, Fairplay, CO 80440. The listed phone number is (719) 836-2055.

What is South Park Ambulance District's specialty?

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

Does South Park Ambulance District hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 06D0698408) is associated with this NPI, valid through August 31, 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 South Park Ambulance District was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.