Robertson Fire Protection District

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

189359 Issued in MO

Legal business name

ROBERTSON FIRE PROTECTION DISTRICT

Practice address

12641 Missouri Bottom Rd
Hazelwood, MO 63042-1517

Phone

(314) 291-6180

NPI assigned

Nov 14, 2005

Organization subpart

No

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

Authorized official

Name

David Tilley

Title

Fire Chief

Phone

(314) 291-6671

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208304000000",
    "number": "1699757997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 771242",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631772242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12641 MISSOURI BOTTOM RD",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630421517",
            "telephone_number": "314-291-6180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERTSON FIRE PROTECTION DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-14",
        "last_updated": "2008-04-16",
        "status": "A",
        "authorized_official_last_name": "TILLEY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "314-291-6671"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MO",
            "license": "189359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NO.",
            "identifier": "122576",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCAREUSA PROV NO.",
            "identifier": "12752",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP PROVIDER NO.",
            "identifier": "33653",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE PROV #",
            "identifier": "8181007",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK PROVIDER NO.",
            "identifier": "112682",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Ruth Richards, M.D.
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• Laura E Riney, SLP
• Riverside Ambulatory Surgery Center, LLC
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• Ashley Donye Robertson, COTA
• Jonnathan Rodriguez, MD
• RTC Legal Nurse Consulting LLC
• Marina Tawfik Russell, MD
• Wendy San Diego, PHARMD

• Land Ambulance in Hazelwood, MO
• Providers in Hazelwood, MO by specialty
• Land Ambulance in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.