Samson Vol. Rescue Squad

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

471 Issued in AL

Legal business name

SAMSON VOL. RESCUE SQUAD

Practice address

9 S Ripley St
Samson, AL 36477-1410

Phone

(334) 898-1153

Fax

(334) 898-1153

NPI assigned

Mar 6, 2007

Organization subpart

No

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

Authorized official

Name

Gary Wiginton, EMR

Title

Captian

Phone

(334) 898-2471

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Samson Rescue Squad Doing business as

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361232000000",
    "number": "1386773091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 22",
            "city": "SAMSON",
            "state": "AL",
            "postal_code": "36477",
            "telephone_number": "334-898-1183",
            "fax_number": "334-898-1153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 S RIPLEY ST",
            "city": "SAMSON",
            "state": "AL",
            "postal_code": "364771410",
            "telephone_number": "334-898-1153",
            "fax_number": "334-898-1153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMSON VOL. RESCUE SQUAD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2013-02-19",
        "status": "A",
        "authorized_official_last_name": "WIGINTON",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "CAPTIAN",
        "authorized_official_telephone_number": "334-898-2471",
        "authorized_official_credential": "EMR"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "AL",
            "license": "471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000050191",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200031101",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Samson Rescue Squad",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Taylor Lane McKnight
• Noomi Healthcare LLC
• Amanda Persaud
• Pieced Together Behavior Services, LLC
• Samson Drugs, Inc
• Christopher C Smith, D.O.
• Stable Change Behavioral Health LLC
• William Hayden Childs, MD, PC
• Tammy Gail Williams, FNP-C
• April Wise, CRNP

• All providers in Samson, AL
• Land Ambulance in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2013; 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.