NPIMap

Organization Active NPI

Mesick Rescue Squad Inc.

  • Land Ambulance
  • Mesick, MI
National Provider Identifier
1063591055
Registry record updated Feb 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
831001 Issued in MI
Legal business name
MESICK RESCUE SQUAD INC.
Practice address
108 S Walter St
Mesick, MI 49668
Phone
(231) 885-1498
NPI assigned
Nov 2, 2006
Last updated
Feb 1, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2012

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

Authorized official

Name
Mr. Allen Sherburne
Title
President
Phone
(231) 885-1498

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 831001 MI Primary

Addresses

Primary practice location

108 S Walter St
Mesick, MI 49668

Mailing address

PO Box 399
Mesick, MI 49668-0399
Phone (231) 885-1498

Other identifiers 2

IdentifierTypeStateIssuer
590H30006OtherMIBLUE CROSS BLUE SHIELD
4365458MedicaidMI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328054400000",
    "number": "1063591055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 399",
            "city": "MESICK",
            "state": "MI",
            "postal_code": "496680399",
            "telephone_number": "231-885-1498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 S WALTER ST",
            "city": "MESICK",
            "state": "MI",
            "postal_code": "49668",
            "telephone_number": "231-885-1498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESICK RESCUE SQUAD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2012-02-01",
        "status": "A",
        "authorized_official_last_name": "SHERBURNE",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "231-885-1498",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MI",
            "license": "831001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "590H30006",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4365458",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesick, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.