Sheridan Fire Protection District

Primary specialty

AmbulanceTaxonomy code 341600000X

License

2564 Issued in IL

Legal business name

SHERIDAN FIRE PROTECTION DISTRICT

Practice address

405 N Bushnell Street
Sheridan, IL 60551-0508

Phone

(815) 496-2296

Fax

(815) 496-3401

NPI assigned

Mar 14, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Kurtis N Tirevold, FF 2, EMT I

Title

Fire Chief

Phone

(815) 496-2296

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339459200000",
    "number": "1417925546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 260",
            "address_2": "2107 GUILES AVENUE",
            "city": "MENDOTA",
            "state": "IL",
            "postal_code": "613420260",
            "telephone_number": "866-570-2468",
            "fax_number": "815-539-6427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 N BUSHNELL STREET",
            "city": "SHERIDAN",
            "state": "IL",
            "postal_code": "605510508",
            "telephone_number": "815-496-2296",
            "fax_number": "815-496-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHERIDAN FIRE PROTECTION DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-14",
        "last_updated": "2012-06-12",
        "status": "A",
        "authorized_official_last_name": "TIREVOLD",
        "authorized_official_first_name": "KURTIS",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "815-496-2296",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "FF 2, EMT I"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "IL",
            "license": "2564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Dorothy Jarka, MS
• Alexandra Paige Melton, ATC
• Lois Nwachukwu, APRN
• Candice Riles-Daniels, LCSW
• Ronald W. Schaefer, M.D.

• Ambulance in Sheridan, IL
• Providers in Sheridan, IL by specialty
• Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; 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.