Organization Active NPI

Township of Mary Ann Trustees

  • Land Ambulance
  • Newark, OH
National Provider Identifier
1043463623
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
N/A Issued in OH
Legal business name
TOWNSHIP OF MARY ANN TRUSTEES
Practice address
6099 Fallsburg Rd NE
Newark, OH 43055-9739
Phone
(740) 345-3645
Fax
(740) 345-0338
NPI assigned
Oct 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Authorized official

Name
Keisha Amspaugh
Title
Fire Chief
Phone
(740) 345-5972

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X N/A OH Primary

Addresses

Primary practice location

6099 Fallsburg Rd NE
Newark, OH 43055-9739

Mailing address

11950 Wilkins Run Rd NE
Newark, OH 43055-9736
Phone (740) 345-3645

Other identifiers 1

IdentifierTypeStateIssuer
2937942MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090225000107 OH Part B Supplier - Ambulance Service Supplier 2062577158 Practice locations: Newark, OH

National Provider Directory

National Provider Directory

Locations

6099 Fallsburg Rd NE
Newark, OH 43055
Phone (740) 345-3918

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692057600000",
    "number": "1043463623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11950 WILKINS RUN RD NE",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430559736",
            "telephone_number": "740-345-3645",
            "fax_number": "740-345-0338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6099 FALLSBURG RD NE",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430559739",
            "telephone_number": "740-345-3645",
            "fax_number": "740-345-0338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWNSHIP OF MARY ANN TRUSTEES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-28",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A",
        "authorized_official_last_name": "AMSPAUGH",
        "authorized_official_first_name": "KEISHA",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "740-345-5972"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OH",
            "license": "N/A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2937942",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; 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.