Old Mystic Fire District

Primary specialty

Basic Emergency Medical TechnicianTaxonomy code 146N00000X

Legal business name

OLD MYSTIC FIRE DISTRICT

Practice address

295 Cow Hill Rd
Mystic, CT 06355-1407

Phone

(860) 536-2220

Fax

(860) 536-7811

NPI assigned

Sep 14, 2015

Last updated

Sep 14, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Kenneth W. Richards Jr.

Title

Fire Chief/Fire Marshal

Phone

(860) 536-2220

Specialties & licenses 1

Addresses

Other names 1

• Old Mystic Fire Department Other name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1442188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442188800000",
    "number": "1073981536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 COW HILL RD",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063551407",
            "telephone_number": "860-536-2220",
            "fax_number": "860-536-7811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 COW HILL RD",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063551407",
            "telephone_number": "860-536-2220",
            "fax_number": "860-536-7811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD MYSTIC FIRE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-14",
        "last_updated": "2015-09-14",
        "status": "A",
        "authorized_official_last_name": "RICHARDS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "FIRE CHIEF/FIRE MARSHAL",
        "authorized_official_telephone_number": "860-536-2220",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medical Technician, Basic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Old Mystic Fire Department",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kayla Nickerson Gauthier, LMFT
• Adam F Niedelman, MD
• Jay Matthew Nieuwenhuis, DC
• Janet A. Noyes, LMFT
• Deirdre Joan Oconnor, N.D.
• Sari Ann Oliver
• Optimystic LLC (OptiMystic Eye Group)
• Brian Kristofer Owczarski
• Lisa Pacifico, P.T.
• Tyler Curtis Page, D.C.

• Basic Emergency Medical Technician in Mystic, CT
• Providers in Mystic, CT by specialty
• Basic Emergency Medical Technician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.