Newport Volunteer Rescue Squad, Inc

Primary specialty

AmbulanceTaxonomy code 341600000X

License

648 Issued in VA

Legal business name

NEWPORT VOLUNTEER RESCUE SQUAD, INC

Practice address

418 Bluegrass Trail
Newport, VA 24128

Phone

(540) 544-7695

NPI assigned

Dec 17, 2009

Last updated

Oct 17, 2012By 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

Ted Harris

Title

President

Phone

(540) 544-7695

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

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

{
    "created_epoch": "1261008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350432000000",
    "number": "1194054387",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 BLUEGRASS TRAIL",
            "city": "NEWPORT",
            "state": "VA",
            "postal_code": "24128",
            "telephone_number": "540-544-7695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWPORT VOLUNTEER RESCUE SQUAD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-17",
        "last_updated": "2012-10-17",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "TED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "540-544-7695"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "VA",
            "license": "648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194054387",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00854631",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelley Ann Brown
• Jane Reynolds Gilbert, COTA/L
• Ta Mara's Promise, LLC

• Ambulance in Newport, VA
• Providers in Newport, VA by specialty
• Ambulance in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; 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.