Organization Active NPI

Washington Volunteer Fire Department and Rescue Squad Inc

  • Land Ambulance
  • Washington, IL
National Provider Identifier
1376576918
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
2586 Issued in IL
Legal business name
WASHINGTON VOLUNTEER FIRE DEPARTMENT AND RESCUE SQUAD INC
Practice address
200 N Wilmore Rd
Washington, IL 61571-1249
Phone
(309) 444-8642
Fax
(309) 444-7421
NPI assigned
Jul 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Authorized official

Name
Sarah Hofstetter
Title
Billing
Phone
(309) 444-8152

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X
Land Ambulance 3416L0300X 2586 IL Primary

Addresses

Primary practice location

200 N Wilmore Rd
Washington, IL 61571-1249

Mailing address

PO Box 322
Washington, IL 61571-0322
Phone (309) 444-2511

Other identifiers 2

IdentifierTypeStateIssuer
590001335OtherILRR MEDICARE
9090008OtherILBCBS

Other names 1

  • Washington Fire Department Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041015000735 IL Part B Supplier - Ambulance Service Supplier 4880654607 Practice locations: Washington, IL

National Provider Directory

National Provider Directory

Locations

200 N Wilmor Rd
Washington, IL 61571
Phone (309) 444-8152

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657670400000",
    "number": "1376576918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 322",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615710322",
            "telephone_number": "309-444-2511",
            "fax_number": "309-444-9532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N WILMORE RD",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615711249",
            "telephone_number": "309-444-8642",
            "fax_number": "309-444-7421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON VOLUNTEER FIRE DEPARTMENT AND RESCUE SQUAD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A",
        "authorized_official_last_name": "HOFSTETTER",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "309-444-8152"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "2586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "590001335",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "9090008",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Washington Fire Department",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Washington Fire Department",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Washington, IL

Sources for this page

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