Bristol Rescue Squad, Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

0701 Issued in VT

Legal business name

BRISTOL RESCUE SQUAD, INC.

Practice address

45 Monkton Road
Bristol, VT 05443

Phone

(802) 453-2513

Fax

(802) 453-2513

NPI assigned

Jan 19, 2007

Last updated

Oct 1, 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

Mark Rickner

Title

Manager

Phone

(802) 453-2472

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in VT

Enrollment records 1

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633046400000",
    "number": "1881747384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 227",
            "city": "BRISTOL",
            "state": "VT",
            "postal_code": "054430227",
            "telephone_number": "802-453-2472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 MONKTON ROAD",
            "city": "BRISTOL",
            "state": "VT",
            "postal_code": "05443",
            "telephone_number": "802-453-2513",
            "fax_number": "802-453-2513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOL RESCUE SQUAD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A",
        "authorized_official_last_name": "RICKNER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "802-453-2472"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "VT",
            "license": "0701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006440",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE INSURANCES",
            "identifier": "VT6440",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Body and Mind Physical Therapy, PLC (Bristol Physical Therapy)
• Marian Ruth Bouchard, MD
• Renee Bratspis, M.D.
• Bristol Internal Medicine, PC
• Bristol Park Dental Associates PLC
• Teresa Marie Burns
• Chiropractic Health & Wellness PC
• Clark Physical Therapy & Bodywork, PLC
• Charles Edward Clark, MD
• Isabelle G Clark

• Land Ambulance in Bristol, VT
• Providers in Bristol, VT by specialty
• Land Ambulance in Vermont

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