Basic Information
| Provider Information | |||||||||
| NPI: | 1710917166 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ACUTE CARE BILLING LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1609 N ANKENY BLVD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | ANKENY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 500234165 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8009623303 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1300 E 5TH AVE | ||||||||
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| City: | WINFIELD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 671562407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6202212300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2006 | ||||||||
| LastUpdateDate: | 07/08/2021 | ||||||||
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| AuthorizedOfficialLastName: | SMITH | ||||||||
| AuthorizedOfficialFirstName: | JARED | ||||||||
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| AuthorizedOfficialTitleorPosition: | ASSISTANT VICE PRESIDENT, CONTROLLE | ||||||||
| AuthorizedOfficialTelephone: | 8007297813 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 07/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 111204 | 01 | KS | BC/BS OF KANSAS | OTHER | 200357450A | 05 | KS | MEDICAID |