Lee County Rescue Squad Thomas Walker Unit Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

9 Issued in VA

Legal business name

LEE COUNTY RESCUE SQUAD THOMAS WALKER UNIT INC

Doing business as

Thomas Walker Rescue Squad

Practice address

170 Pioneer Road
Ewing, VA 24248-0001

Phone

(276) 445-1150

Fax

(865) 362-3863

NPI assigned

Apr 1, 2008

Last updated

Jun 9, 2021By 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

Floyd J Long

Title

President

Phone

(276) 445-1150

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Thomas Walker Rescue Squad Doing business as

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": "1207008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623196800000",
    "number": "1295907095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9150",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420029150",
            "telephone_number": "270-744-8413",
            "fax_number": "270-744-8642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 PIONEER ROAD",
            "city": "EWING",
            "state": "VA",
            "postal_code": "242480001",
            "telephone_number": "276-445-1150",
            "fax_number": "865-362-3863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEE COUNTY RESCUE SQUAD THOMAS WALKER UNIT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-01",
        "last_updated": "2021-06-09",
        "certification_date": "2021-05-25",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "FLOYD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "276-445-1150"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "VA",
            "license": "9",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295907095",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thomas Walker Rescue Squad",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Thomas Walker Rescue Squad",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Vanessa Jill Sutphin-Mayes, PT
• Joshua A Yeary, DO

• Land Ambulance in Ewing, VA
• Providers in Ewing, VA by specialty
• Land Ambulance in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.