Fort Ann Rescue Squad Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

FORT ANN RESCUE SQUAD INC

Practice address

11287 State Route 149
Fort Ann, NY 12827

Phone

(518) 639-1005

NPI assigned

Nov 23, 2005

Organization subpart

No

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

Authorized official

Name

Jordan T. Neumann

Title

President

Phone

(518) 639-1005

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607040000000",
    "number": "1477536381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8610 MAIN STREET",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142217455",
            "telephone_number": "716-204-3350",
            "fax_number": "716-247-5274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11287 STATE ROUTE 149",
            "city": "FORT ANN",
            "state": "NY",
            "postal_code": "12827",
            "telephone_number": "518-639-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT ANN RESCUE SQUAD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-23",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A",
        "authorized_official_last_name": "NEUMANN",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "518-639-1005"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NY",
            "license": "10258",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA RAILROAD",
            "identifier": "590011141",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10025830",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01767817",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "958231",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emmett Rhett Eubanks, LCSW
• Fort Ann Central School
• Suzanne Marie Loparnos, M.S., CCC-SLP
• Jesse Matteson, OTR/L
• Rachel McQueen, M.S., LCAT, MT-BC
• Robert Vincent Morse II, PSY.D.
• Debra Darlene Newton, LPN

• Land Ambulance in Fort Ann, NY
• Providers in Fort Ann, NY by specialty
• Land Ambulance in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; 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.