Bloxom Volunteer Fire Company

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

BLOXOM VOLUNTEER FIRE COMPANY

Practice address

15312 Bayside Dr
Bloxom, VA 23308-2820

Phone

(757) 665-5169

NPI assigned

May 24, 2006

Last updated

Dec 7, 2020By 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

James Bagwell

Title

Chief

Phone

(757) 665-4651

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607299200000",
    "number": "1609821792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 132",
            "city": "BLOXOM",
            "state": "VA",
            "postal_code": "233080132",
            "telephone_number": "270-744-9600",
            "fax_number": "270-744-8642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15312 BAYSIDE DR",
            "city": "BLOXOM",
            "state": "VA",
            "postal_code": "233082820",
            "telephone_number": "757-665-5169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOXOM VOLUNTEER FIRE COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A",
        "authorized_official_last_name": "BAGWELL",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "757-665-4651"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "VA",
            "license": "454",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA",
            "identifier": "29304",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR CARE",
            "identifier": "590014049",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009013601",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "432960",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bossy Bundle & Wig Collection LLC
• Trinice Duffy, BCBA

• Land Ambulance in Bloxom, VA
• Providers in Bloxom, VA by specialty
• Land Ambulance in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.