Taylor County Emergency Squad

Primary specialty

AmbulanceTaxonomy code 341600000X

License

54633 Issued in WV

Legal business name

TAYLOR COUNTY EMERGENCY SQUAD

Practice address

797 George Washington Hwy.
Grafton, WV 26354

Phone

(304) 265-0904

Fax

(304) 265-0906

NPI assigned

May 4, 2007

Organization subpart

No

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

Authorized official

Name

Gavin Watkins

Title

Director

Phone

(304) 265-0904

Specialties & licenses 4

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in WV

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

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690848000000",
    "number": "1770795353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 161",
            "city": "GRAFTON",
            "state": "WV",
            "postal_code": "26354",
            "telephone_number": "304-265-0904",
            "fax_number": "304-265-0906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "797 GEORGE WASHINGTON HWY.",
            "city": "GRAFTON",
            "state": "WV",
            "postal_code": "26354",
            "telephone_number": "304-265-0904",
            "fax_number": "304-265-0906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAYLOR COUNTY EMERGENCY SQUAD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A",
        "authorized_official_last_name": "WATKINS",
        "authorized_official_first_name": "GAVIN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "304-265-0904"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "WV",
            "license": "54633",
            "primary": true
        },
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "WV",
            "license": null,
            "primary": false
        },
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOUNTAIN STATE BCBS",
            "identifier": "000207283",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0145530000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA HEALTH RETIREMENT FU",
            "identifier": "0161950",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA HEALTH RETIREMENT FUN",
            "identifier": "0161950",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lantz Swisher
• Amber N Tacy
• Joyce Tacy
• Taylor County Board of Education
• Taylor County Board of Education
• Taylor County Senior Citizens, Inc.
• Taylor County Senior Citizens, Inc.
• Taylor Health Care Center, LLC
• Taylor SNF LLC
• Jimi Paulette Taylor

• Ambulance in Grafton, WV
• Providers in Grafton, WV by specialty
• Ambulance in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; 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.