Brookside Volunteer Fire Company

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

BROOKSIDE VOLUNTEER FIRE COMPANY

Practice address

3560 Athens St
Erie, PA 16510-3012

Phone

(814) 899-3820

Fax

(814) 899-1479

NPI assigned

Jan 9, 2006

Last updated

Feb 16, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Todd A Bishop

Title

President

Phone

(814) 889-3820

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• Brookside Fire Company Inc Other name

Medicare fee-for-service enrollment

Enrolled in PA

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": "1136764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487203200000",
    "number": "1730167834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3560 ATHENS ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165103012",
            "telephone_number": "814-899-3820",
            "fax_number": "814-899-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3560 ATHENS ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165103012",
            "telephone_number": "814-899-3820",
            "fax_number": "814-899-1479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKSIDE VOLUNTEER FIRE COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-09",
        "last_updated": "2017-02-16",
        "status": "A",
        "authorized_official_last_name": "BISHOP",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-889-3820"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010890570003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY HEALTH PLAN",
            "identifier": "1501732",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010890570001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC HEALTH",
            "identifier": "250344",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE/PALMETTO GBA",
            "identifier": "590011960",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMERICA",
            "identifier": "339394",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "285123",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookside Fire Company Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• James David Brodell Jr., MD
• Brandi Roxanne Brooks, CRNP
• Diana Brooks, HIS
• Jill Marie Brooks, RD, LDN, CDE
• Larissa Brooks
• Kayelyn Brophy
• Carole Brosius
• Bobbie Brotherson, DO
• Gary T Brotherson, M.D.
• Christina K Brown, M.D.

• Land Ambulance in Erie, PA
• Providers in Erie, PA by specialty
• Land Ambulance in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; 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.