Fayetteville Fire Department, Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

020427852 Issued in OH

Legal business name

FAYETTEVILLE FIRE DEPARTMENT, INC.

Practice address

100 N. Apple St.
Fayetteville, OH 45118

Phone

(513) 875-2202

NPI assigned

Feb 14, 2014

Last updated

May 14, 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

Jennifer A Rosselot

Title

Asst. Treasurer

Phone

(513) 875-3824

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

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

{
    "created_epoch": "1392336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715644800000",
    "number": "1548684210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 392907",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152519907",
            "telephone_number": "800-962-1484",
            "fax_number": "513-772-4464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N. APPLE ST.",
            "city": "FAYETTEVILLE",
            "state": "OH",
            "postal_code": "45118",
            "telephone_number": "513-875-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYETTEVILLE FIRE DEPARTMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-14",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A",
        "authorized_official_last_name": "ROSSELOT",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ASST. TREASURER",
        "authorized_official_telephone_number": "513-875-3824"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OH",
            "license": "020427852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000007951",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0102894",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jarrod Dumford
• Sara A Egan
• Christina Lynn Evans, LPN
• Family Alliance at Home Care LLC
• Family Alliance Care, LLC
• Fayetteville-Perry Local Schools
• Brittany Noel Hall
• Katherine J Hauke
• Kristina W. Hesser, R.N.
• Bertha Ann Hooley

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.