Active NPI
Haysi Rescue Squad, Inc.
- Land Ambulance
- Haysi, VA
National Provider Identifier
1215975982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 371
- Legal business name
- HAYSI RESCUE SQUAD, INC.
- Practice address
- 160 Sandlick Road
Haysi, VA 24256 - Phone
- (276) 865-4065
- NPI assigned
- Jun 3, 2006
- Last updated
- Mar 15, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Terry Bartley
- Title
- Captain
- Phone
- (276) 644-4987
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 371 | VA | Primary |
Addresses
Primary practice location
160 Sandlick Road
Haysi, VA 24256
Mailing address
PO Box 329
Haysi, VA 24256-0329
Phone (877) 731-5464
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010284988 | Medicaid | VA | |
| 267589 | Other | VA | ANTHEM BLUE CROSS |
| 611927000 | Other | VA | BLACK LUNG DCMMC |
| ========= | Other | VA | TRICARE |
| ========= | Other | VA | UMWA HEALTH & RETIREMENT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061102000222 | VA | Part B Supplier - Ambulance Service Supplier | 4880691948 | Practice locations: Haysi, VA |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149292800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1710460800000",
"number": "1215975982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 329",
"city": "HAYSI",
"state": "VA",
"postal_code": "242560329",
"telephone_number": "877-731-5464",
"fax_number": "800-234-1627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 SANDLICK ROAD",
"city": "HAYSI",
"state": "VA",
"postal_code": "24256",
"telephone_number": "276-865-4065"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HAYSI RESCUE SQUAD, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-03",
"last_updated": "2024-03-15",
"certification_date": "2024-03-15",
"status": "A",
"authorized_official_last_name": "BARTLEY",
"authorized_official_first_name": "TERRY",
"authorized_official_title_or_position": "CAPTAIN",
"authorized_official_telephone_number": "276-644-4987"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "VA",
"license": "371",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010284988",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS",
"identifier": "267589",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLACK LUNG DCMMC",
"identifier": "611927000",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "=========",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UMWA HEALTH & RETIREMENT",
"identifier": "=========",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Haysi, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.