Town of Bridgewater

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

0392 Issued in NH

Legal business name

TOWN OF BRIDGEWATER

Practice address

311 Mayhew Tpke
Bridgewater, NH 03222-5215

Phone

(603) 744-6047

NPI assigned

Aug 31, 2005

Organization subpart

No

Name

Jacob Fogarty

Title

EMS Director

Phone

(603) 744-6047

Medicare fee-for-service enrollment

Enrolled in NH

Locations

• Bridgewater Public Safety EMS Department Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 19, 2018.

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539907200000",
    "number": "1700879137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 TURCOTTE MEMORIAL DR",
            "city": "ROWLEY",
            "state": "MA",
            "postal_code": "019691706",
            "telephone_number": "800-488-4351",
            "fax_number": "978-356-2721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 MAYHEW TPKE",
            "city": "BRIDGEWATER",
            "state": "NH",
            "postal_code": "032225215",
            "telephone_number": "603-744-6047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN OF BRIDGEWATER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-31",
        "last_updated": "2018-10-19",
        "status": "A",
        "authorized_official_last_name": "FOGARTY",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "EMS DIRECTOR",
        "authorized_official_telephone_number": "603-744-6047"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NH",
            "license": "0392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "71Y008099NH01",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridgewater Public Safety EMS Department",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bridgewater Public Safety EMS Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberly Denton, MS CCC-SLP

• All providers in Bridgewater, NH
• Land Ambulance in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2018; 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.