County of Bradley County Fund

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

EMS0000000601 Issued in TN

Legal business name

COUNTY OF BRADLEY COUNTY FUND

Doing business as

Bradley County Emergency Medical Services

Practice address

499 Paul Huff Pkwy NW
Cleveland, TN 37312-2968

Phone

(423) 728-7010

Fax

(423) 476-0496

NPI assigned

Dec 16, 2005

Last updated

Apr 12, 2024By 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

Jennifer Stacy

Title

Office Manager

Phone

(423) 728-7010

Specialties & licenses 1

Addresses

Other names 1

• Bradley County Emergency Medical Services Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712880000000",
    "number": "1841276300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1167",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373641167",
            "telephone_number": "423-728-7010",
            "fax_number": "423-476-0496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 PAUL HUFF PKWY NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373122968",
            "telephone_number": "423-728-7010",
            "fax_number": "423-476-0496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF BRADLEY COUNTY FUND",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-16",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A",
        "authorized_official_last_name": "STACY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "423-728-7010"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "TN",
            "license": "EMS0000000601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bradley County Emergency Medical Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alexander Gabriel Corey, DMD
• Kathryn Carson Corley, BEHAVIOR TECHNICIAN
• Katelyn Cornett, OTR/L
• Elizabeth Ann Couillard, CRNA
• Heather Coulston
• Covenant Life Management, LLC
• Jessica Moriah Covert, ATC
• Cox Vision Center PC
• Ashley Cox
• Tanner Luke Cox, DPT

• Land Ambulance in Cleveland, TN
• Providers in Cleveland, TN by specialty
• Land Ambulance in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; 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.