Jeb Stuart Rescue Squad Incorporated

Primary specialty

AmbulanceTaxonomy code 341600000X

License

158 Issued in VA

Legal business name

JEB STUART RESCUE SQUAD INCORPORATED

Practice address

1258 American Legion Rd
Stuart, VA 24171

Phone

(276) 694-6171

Fax

(276) 694-5366

NPI assigned

Jun 14, 2006

Last updated

Sep 13, 2022By 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

Jimmy Willard

Title

President

Phone

(276) 229-6272

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663027200000",
    "number": "1306889431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 290184",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061290184",
            "telephone_number": "860-257-7080",
            "fax_number": "860-563-3403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1258 AMERICAN LEGION RD",
            "city": "STUART",
            "state": "VA",
            "postal_code": "24171",
            "telephone_number": "276-694-6171",
            "fax_number": "276-694-5366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEB STUART RESCUE SQUAD INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A",
        "authorized_official_last_name": "WILLARD",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "276-229-6272"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "VA",
            "license": "158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010209196",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sydney Biggs Hopkins, OTD, OTR/L
• Betsy Hubbard, RBT
• Ryan C Hubbard, D.O.
• Kara Hughes
• Gregory Todd Hutchens, D.D.S.
• Teresa Jetmar, LPC
• Shonda Jones, MSN, APRN, FNP-BC
• Milbourne L Joye Jr., RD LDN
• India Brooke Kahle, COTA/L
• Kam's Corner, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; 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.