Jefferson County Emergency Services Agency

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

WV EMS Issued in WV

Legal business name

JEFFERSON COUNTY EMERGENCY SERVICES AGENCY

Practice address

419 16TH Ave
Ranson, WV 25438-5732

Phone

(304) 839-6319

Fax

(304) 728-6221

NPI assigned

Oct 4, 2011

Last updated

Oct 4, 2024By 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

Theodore Michael Sine

Title

Director

Phone

(304) 433-5378

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

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

{
    "created_epoch": "1317686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728000000000",
    "number": "1144504630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 4TH AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257011407",
            "telephone_number": "304-521-1576",
            "fax_number": "304-521-1576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 16TH AVE",
            "city": "RANSON",
            "state": "WV",
            "postal_code": "254385732",
            "telephone_number": "304-839-6319",
            "fax_number": "304-728-6221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON COUNTY EMERGENCY SERVICES AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-04",
        "last_updated": "2024-10-04",
        "status": "A",
        "authorized_official_last_name": "SINE",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "304-433-5378"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WV",
            "license": "WV EMS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810022558",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jefferson County Council on Aging
• Jefferson County Council on Aging
• Jefferson County Council on Aging
• Jefferson County Council on Aging
• Jefferson County Council on Aging - JC
• Jefferson Med-Peds Inc
• Jefferson Memorial Hospital
• Jefferson Memorial Hospital
• Jefferson Memorial Hospital
• Jefferson Memorial Hospital

• Land Ambulance in Ranson, WV
• Providers in Ranson, WV by specialty
• Land Ambulance in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; 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.