Elk Creek Rescue Squad Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

ELK CREEK RESCUE SQUAD INC

Practice address

9109 Elk Creek Parkway
Elk Creek, VA 24326

Phone

(276) 655-4240

Fax

(276) 655-4936

NPI assigned

Jul 13, 2017

Organization subpart

No

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

Authorized official

Name

Jamie Carpenter

Title

Captain

Phone

(276) 655-4240

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618531200000",
    "number": "1255853016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "ELK CREEK",
            "state": "VA",
            "postal_code": "243260130",
            "telephone_number": "276-655-4240",
            "fax_number": "276-655-4936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9109 ELK CREEK PARKWAY",
            "city": "ELK CREEK",
            "state": "VA",
            "postal_code": "24326",
            "telephone_number": "276-655-4240",
            "fax_number": "276-655-4936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELK CREEK RESCUE SQUAD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-13",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A",
        "authorized_official_last_name": "CARPENTER",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "CAPTAIN",
        "authorized_official_telephone_number": "276-655-4240"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "VA",
            "license": "684",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tayler Hale
• Autumn Hart, OTR/L
• Elizabeth Ann Jones, FNP-BC
• Lynne D. Smith, COTA/L

• Land Ambulance in Elk Creek, VA
• Providers in Elk Creek, VA by specialty
• Land Ambulance in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; 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.