NPIMap

Organization Active NPI

Bradford Rescue Squad

  • Land Ambulance
  • Bradford, IL
National Provider Identifier
1265573612
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
BRADFORD RESCUE SQUAD
Practice address
241 W Main Street
Bradford, IL 61421-0040
Phone
(309) 682-5280
Fax
(309) 682-5327
NPI assigned
Feb 9, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Sharon Stotler
Title
President
Phone
(309) 493-5112

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X IL Primary

Addresses

Primary practice location

241 W Main Street
Bradford, IL 61421-0040

Mailing address

PO Box 40
241 W Main Street
Bradford, IL 61421-0020
Phone (309) 682-5280

Other identifiers 2

IdentifierTypeStateIssuer
P00227106OtherILPALMETTO GBA
08832003OtherILBLUE CROSS

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265573612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "address_2": "241 W MAIN STREET",
            "city": "BRADFORD",
            "state": "IL",
            "postal_code": "614210020",
            "telephone_number": "309-682-5280",
            "fax_number": "309-682-5327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 W MAIN STREET",
            "city": "BRADFORD",
            "state": "IL",
            "postal_code": "614210040",
            "telephone_number": "309-682-5280",
            "fax_number": "309-682-5327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADFORD RESCUE SQUAD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STOTLER",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-493-5112"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "P00227106",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "08832003",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.