Active NPI
Cortland Community Fire Protection District
- Land Ambulance
- Cortland, IL
National Provider Identifier
1407205685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 01 1429
- Legal business name
- CORTLAND COMMUNITY FIRE PROTECTION DISTRICT
- Practice address
- 30 W North Ave
Cortland, IL 60112-4051 - Phone
- (815) 756-2545
- NPI assigned
- Jun 8, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Trent Moser, FF/PM
- Title
- Fire Chief
- Phone
- (815) 756-2545
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 01 1429 | IL | Primary |
Addresses
Primary practice location
30 W North Ave
Cortland, IL 60112-4051
Mailing address
30 W North Ave
Cortland, IL 60112-4051
Phone (815) 756-2545
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160909001140 | IL | Part B Supplier - Ambulance Service Supplier | 5294021705 | Practice locations: Cortland, IL |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465344000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1465344000000",
"number": "1407205685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 W NORTH AVE",
"city": "CORTLAND",
"state": "IL",
"postal_code": "601124051",
"telephone_number": "815-756-2545"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 W NORTH AVE",
"city": "CORTLAND",
"state": "IL",
"postal_code": "601124051",
"telephone_number": "815-756-2545"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CORTLAND COMMUNITY FIRE PROTECTION DISTRICT",
"organizational_subpart": "NO",
"enumeration_date": "2016-06-08",
"last_updated": "2016-06-08",
"status": "A",
"authorized_official_last_name": "MOSER",
"authorized_official_first_name": "TRENT",
"authorized_official_title_or_position": "FIRE CHIEF",
"authorized_official_telephone_number": "815-756-2545",
"authorized_official_credential": "FF/PM"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "IL",
"license": "01 1429",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cortland, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.