Kirkland Community Fire District

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

11048 Issued in IL

Legal business name

KIRKLAND COMMUNITY FIRE DISTRICT

Practice address

3891 State Route 72
Kirkland, IL 60146-8635

Phone

(815) 522-4414

Fax

(815) 522-4414

NPI assigned

Mar 8, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Michael Paull Stott

Title

Deputy Chief

Phone

(815) 276-4235

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Kirkland Fire & Rescue Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281052800000",
    "number": "1679604151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3891 RR # 72",
            "address_2": "BOX 657",
            "city": "KIRKLAND",
            "state": "IL",
            "postal_code": "60146",
            "telephone_number": "815-522-4414",
            "fax_number": "815-522-6132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3891 STATE ROUTE 72",
            "city": "KIRKLAND",
            "state": "IL",
            "postal_code": "601468635",
            "telephone_number": "815-522-4414",
            "fax_number": "815-522-4414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIRKLAND COMMUNITY FIRE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2010-08-06",
        "status": "A",
        "authorized_official_last_name": "STOTT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "PAULL",
        "authorized_official_title_or_position": "DEPUTY CHIEF",
        "authorized_official_telephone_number": "815-276-4235",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "11048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01970849",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "01970849",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kirkland Fire & Rescue",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Kirkland, IL
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2010; 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.