Nunda Rural Fire Protection Dist Fire & Rescue Insur & Audit

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

7139 Issued in IL

Legal business name

NUNDA RURAL FIRE PROTECTION DIST FIRE & RESCUE INSUR & AUDIT

Practice address

1713 Route 176
Crystal Lake, IL 60014

Phone

(815) 455-1559

Fax

(847) 577-7967

NPI assigned

Jun 15, 2006

Last updated

Aug 8, 2012By 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

William Hoover

Title

Fire Chief

Phone

(815) 455-1559

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344384000000",
    "number": "1336183094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 457",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600900457",
            "telephone_number": "847-577-8811",
            "fax_number": "847-577-7967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1713 ROUTE 176",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "60014",
            "telephone_number": "815-455-1559",
            "fax_number": "847-577-7967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUNDA RURAL FIRE PROTECTION DIST FIRE & RESCUE INSUR & AUDIT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2012-08-08",
        "status": "A",
        "authorized_official_last_name": "HOOVER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "815-455-1559"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "7139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5632048",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS MEDIGAP",
            "identifier": "299334",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; 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.