Ada-Liberty JT Ambulance Dis

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

020304150 Issued in OH

Legal business name

ADA-LIBERTY JT AMBULANCE DIS

Practice address

530 North Gilbert Street
Ada, OH 45810

Phone

(419) 634-7729

Fax

(419) 634-5290

NPI assigned

Jun 15, 2007

Last updated

Nov 4, 2016By 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

Nancy D Bucher

Title

Fiscal Officer

Phone

(419) 634-7729

Specialties & licenses 1

Addresses

Other identifiers 3

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": "1181865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478217600000",
    "number": "1356546808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10361 SPARTAN DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452151220",
            "telephone_number": "800-962-1484",
            "fax_number": "513-772-4464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NORTH GILBERT STREET",
            "city": "ADA",
            "state": "OH",
            "postal_code": "45810",
            "telephone_number": "419-634-7729",
            "fax_number": "419-634-5290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADA-LIBERTY JT AMBULANCE DIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-15",
        "last_updated": "2016-11-04",
        "status": "A",
        "authorized_official_last_name": "BUCHER",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "FISCAL OFFICER",
        "authorized_official_telephone_number": "419-634-7729"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OH",
            "license": "020304150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0265672",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590175429",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000156090",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aaron Hermiller Counseling Service
• Ada Exempted Village School District
• Ada Family Dentistry
• Ada Physical Therapy LLC
• Brandon Adams
• Eyob D Adane, PHD, RPH
• Akeem A Adeniyi, CNP
• Nicholas Alger, LMT.
• Becky Jo Armentrout, OT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2016; 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.