Blackhawk Fire Protection District

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

BLACKHAWK FIRE PROTECTION DISTRICT

Practice address

3738 S Main St
Rockford, IL 61102-4239

Phone

(815) 962-1584

Fax

(815) 962-4275

NPI assigned

Apr 9, 2020

Last updated

Jul 13, 2022By 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

Jonathan Trail

Title

Fire Chief

Phone

(815) 962-1584

Specialties & licenses 1

Addresses

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": "1586390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657670400000",
    "number": "1740809870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 260",
            "city": "MENDOTA",
            "state": "IL",
            "postal_code": "613420260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3738 S MAIN ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611024239",
            "telephone_number": "815-962-1584",
            "fax_number": "815-962-4275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKHAWK FIRE PROTECTION DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-09",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A",
        "authorized_official_last_name": "TRAIL",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "815-962-1584"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Bitner, P.T.
• Linda Bjur, LCSW
• David A Black, PT, MS, OCS
• Leon B Black, MSW LCSW CCBT CPTP
• Megan Blackburn
• Blackhawk Park School
• Michaela Rose Blackwell, PA-C
• Shawn Michael Bladel, DC
• Elizabeth Blair, APN
• Thuy Nguyen Blair, PHARMD

• Land Ambulance in Rockford, IL
• Providers in Rockford, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.