Jefferson Emergency Rescue District

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

JEFFERSON EMERGENCY RESCUE DISTRICT

Practice address

11 S Market St
Jefferson, OH 44047-1422

Phone

(440) 576-4367

Fax

(440) 576-5675

NPI assigned

Mar 15, 2007

Last updated

Jun 18, 2024By 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. Jake Rice

Title

Chief

Phone

(440) 576-4367

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Tax ID family

Jefferson Township Fire Department3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Jefferson Township BD of Trustees

  • Ambulance
  • Dayton, OH
  • NPI 1275742439
  NPD tax ID
• Jefferson Township Fire Department

  • Ambulance
  • Dayton, OH
  • NPI 1992923999
  NPD tax ID

Locations

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718668800000",
    "number": "1376677864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2122",
            "city": "RIVERVIEW",
            "state": "MI",
            "postal_code": "481931122",
            "telephone_number": "800-926-6985",
            "fax_number": "734-479-6319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 S MARKET ST",
            "city": "JEFFERSON",
            "state": "OH",
            "postal_code": "440471422",
            "telephone_number": "440-576-4367",
            "fax_number": "440-576-5675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON EMERGENCY RESCUE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2024-06-18",
        "certification_date": "2024-05-31",
        "status": "A",
        "authorized_official_last_name": "RICE",
        "authorized_official_first_name": "JAKE",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "440-576-4367",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0292955",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Danielle Horowski, LPN
• Evan Cecil Howe, MD, PHD, MPH
• Shannon Leigh Hudson, LPN
• Marsha Ann Hunter, R.N.
• Jefferson Area Local School District
• Jefferson Health Center
• Jefferson Medical Associates, LLC (Jefferson Healthcare Center)
• Jefferson Rehabilitation and Wellness LLC (Integrative Physical Therapy Concepts, LLC)
• Darcy Jo Johnson
• Tracie King

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.