Township of Lyon Roscommon County

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

TOWNSHIP OF LYON ROSCOMMON COUNTY

Doing business as

Lyon Township Fire Department

Practice address

7851 W Higgins Lake Dr
Roscommon, MI 48653-8867

Phone

(989) 821-9694

Fax

(989) 821-5118

NPI assigned

Jun 8, 2006

Organization subpart

No

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

Authorized official

Name

JC Holder

Title

Fire Chief

Phone

(989) 915-2725

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Lyon Township Fire Department Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722816000000",
    "number": "1699715458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2122",
            "city": "RIVERVIEW",
            "state": "MI",
            "postal_code": "481931122",
            "telephone_number": "734-479-6300",
            "fax_number": "734-479-6319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7851 W HIGGINS LAKE DR",
            "city": "ROSCOMMON",
            "state": "MI",
            "postal_code": "486538867",
            "telephone_number": "989-821-9694",
            "fax_number": "989-821-5118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWNSHIP OF LYON ROSCOMMON COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A",
        "authorized_official_last_name": "HOLDER",
        "authorized_official_first_name": "JC",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "989-915-2725"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "MI",
            "license": "721002",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "590G200030",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184088376",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lyon Township Fire Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Timothy J Thornton, MD
• Charlene Anne Titchenell
• Jessica Tjapkes
• Township Board of South Branch
• Township of Gerrish
• Angela Joan Vanderkarr, FNP-C
• Jeff Vanwormer, R. PH.
• Roberto Amponin Viguilla, M.D.
• Village Family Medicine PC
• Bethany Ward

• Land Ambulance in Roscommon, MI
• Providers in Roscommon, MI by specialty
• Land Ambulance in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.