Cambridge Rescue Squad Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

0413 Issued in VT

Legal business name

CAMBRIDGE RESCUE SQUAD INC.

Practice address

18 Williamson Court
Jeffersonville, VT 05464

Phone

(802) 644-2113

NPI assigned

Nov 7, 2006

Last updated

Aug 22, 2020By 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

Mr. David Bernard Severance

Title

Chief

Phone

(802) 644-2113

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in VT

Enrollment records 1

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356410286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 431",
            "city": "JEFFERSONVILLE",
            "state": "VT",
            "postal_code": "054640431",
            "telephone_number": "802-644-2113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 WILLIAMSON COURT",
            "city": "JEFFERSONVILLE",
            "state": "VT",
            "postal_code": "05464",
            "telephone_number": "802-644-2113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMBRIDGE RESCUE SQUAD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SEVERANCE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "BERNARD",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "802-644-2113",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "VT",
            "license": "0413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ID NUMBER",
            "identifier": "19659",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0VN0774",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Jeffersonville, VT
• Providers in Jeffersonville, VT by specialty
• Land Ambulance in Vermont

• 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.
• 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.