The Mohegan Fire Company Incorporated

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

THE MOHEGAN FIRE COMPANY INCORPORATED

Practice address

2029 Norwich New London Tpke
Uncasville, CT 06382-1330

Phone

(860) 848-3004

NPI assigned

Sep 19, 2005

Organization subpart

No

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

Authorized official

Name

Corey Gaetano

Title

Chief

Phone

(860) 848-3004

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666224000000",
    "number": "1679568323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2029 NORWICH NEW LONDON TPKE",
            "city": "UNCASVILLE",
            "state": "CT",
            "postal_code": "063821330",
            "telephone_number": "608-483-0048",
            "fax_number": "860-848-9038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2029 NORWICH NEW LONDON TPKE",
            "city": "UNCASVILLE",
            "state": "CT",
            "postal_code": "063821330",
            "telephone_number": "860-848-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MOHEGAN FIRE COMPANY INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-19",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A",
        "authorized_official_last_name": "GAETANO",
        "authorized_official_first_name": "COREY",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "860-848-3004"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590014884",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "CU3445",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004136108",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "710C086B3CT01",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Regina Ann Strand, OD
• Sunshine Elderly Care, LLC
• Mary Rose Gotardo Tantoco, M.D.
• Kristen Tarbell, BCBA
• Dessiray Taylor
• The Mohegan Tribe of Indians of Connecticut
• Total Vision-Eye Health Center LLC
• Danielle C Trudeau, DDS
• Mya-Ann Takara Tschopp
• Jennifer Tuohy, P.T.

• Land Ambulance in Uncasville, CT
• Providers in Uncasville, CT by specialty
• Land Ambulance in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; 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.