Town of Clinton

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

160 Issued in ME

Legal business name

TOWN OF CLINTON

Practice address

27 Baker St
Clinton, ME 04927-3551

Phone

(800) 964-9200

NPI assigned

Apr 2, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gary Petley

Title

Fire Chief

Phone

(800) 964-9200

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Clinton Ambulance Doing business as

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364947200000",
    "number": "1043330947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 BAKER ST",
            "city": "CLINTON",
            "state": "ME",
            "postal_code": "049273551",
            "telephone_number": "800-964-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 BAKER ST",
            "city": "CLINTON",
            "state": "ME",
            "postal_code": "049273551",
            "telephone_number": "800-964-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN OF CLINTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2013-04-03",
        "status": "A",
        "authorized_official_last_name": "PETLEY",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "800-964-9200"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "ME",
            "license": "160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136360000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinton Ambulance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristine Moses Hatch, LMT, IHP2, MBSR-P
• Leroy Allen Holt
• Lisa Hunter
• Shelly A Thibodeau, RN
• Cheryl Anne Towle
• Stephen Wicker, R.PH.

• All providers in Clinton, ME
• Land Ambulance in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.