Jackson Township Trustees

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

02-0301400 Issued in OH

Legal business name

JACKSON TOWNSHIP TRUSTEES

Practice address

7383 Fulton Dr NW
Massillon, OH 44646-9393

Phone

(330) 834-3950

Fax

(330) 834-3958

NPI assigned

Oct 10, 2006

Organization subpart

No

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

Authorized official

Name

Timothy G Berczik

Title

Fire Chief

Phone

(330) 834-3952

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714521600000",
    "number": "1356439152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5735 WALES AVE NW",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446469097",
            "telephone_number": "330-832-7416",
            "fax_number": "330-832-5936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7383 FULTON DR NW",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446469393",
            "telephone_number": "330-834-3950",
            "fax_number": "330-834-3958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON TOWNSHIP TRUSTEES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A",
        "authorized_official_last_name": "BERCZIK",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "330-834-3952"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OH",
            "license": "02-0301400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0112541",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Isom Associates, Inc.
• Christina Ivan
• J Danzy Creates LLC
• J. Douglas Paulus D.D.S. Inc.
• Jaa Bussey Inc
• Cortnie Jackson
• Ebony S Jackson
• Sandra Lynn Jackson, COTA
• Tammy L Jackson
• Cynthia W Jacobs, M.A.

• Land Ambulance in Massillon, OH
• Providers in Massillon, OH by specialty
• Land Ambulance in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; 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.