Buckeye Lake Village

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

BUCKEYE LAKE VILLAGE

Practice address

10920 Hebron Road SE
Buckeye Lake, OH 43008

Phone

(740) 928-3473

NPI assigned

Aug 29, 2013

Organization subpart

No

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) 616-0112

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

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

{
    "created_epoch": "1377734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702252800000",
    "number": "1164856852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10920 HEBRON ROAD SE",
            "address_2": "P.O. BOX 27",
            "city": "BUCKEYE LAKE",
            "state": "OH",
            "postal_code": "43008",
            "telephone_number": "740-928-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10920 HEBRON ROAD SE",
            "city": "BUCKEYE LAKE",
            "state": "OH",
            "postal_code": "43008",
            "telephone_number": "740-928-3473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCKEYE LAKE VILLAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-29",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A",
        "authorized_official_last_name": "AMSPAUGH",
        "authorized_official_first_name": "KEISHA",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "740-616-0112"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl A Battle, RN
• Buckeye Lake Dental LLC
• Compass Counseling Group
• Deanna Tucker
• Debra Ziadeh
• Sandra Dawn Facemire, MSW, LISW-S
• Emily J Gilgien

• Land Ambulance in Buckeye Lake, OH
• Providers in Buckeye Lake, OH by specialty
• Land Ambulance in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.