City of Fort Mitchell Office of Treasurer

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

CITY OF FORT MITCHELL OFFICE OF TREASURER

Doing business as

Fort Mitchell Life Squad

Practice address

2355 Dixie Hwy
Ft Mitchell, KY 41017-2948

Phone

(859) 331-1267

Fax

(859) 331-6102

NPI assigned

Jul 14, 2005

Last updated

Mar 12, 2021By 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

Adam L Fuller

Title

Chief

Phone

(859) 331-1267

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Fort Mitchell Life Squad Doing business as

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615507200000",
    "number": "1780683532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9150",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420029150",
            "telephone_number": "270-744-9600",
            "fax_number": "270-744-8642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 DIXIE HWY",
            "city": "FT MITCHELL",
            "state": "KY",
            "postal_code": "410172948",
            "telephone_number": "859-331-1267",
            "fax_number": "859-331-6102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF FORT MITCHELL OFFICE OF TREASURER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-14",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "859-331-1267"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2513613",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000039205",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55059166",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHA",
            "identifier": "000001199826",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fort Mitchell Life Squad",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fort Mitchell Life Squad",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Land Ambulance in Ft Mitchell, KY
• Providers in Ft Mitchell, KY by specialty
• Land Ambulance in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; 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.