Allen Clay Joint Fire District

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

ALLEN CLAY JOINT FIRE DISTRICT

Practice address

3155 N. Genoa Clay Center Rd
Genoa, OH 43430-9464

Phone

(419) 855-4733

Fax

(419) 855-1074

NPI assigned

May 19, 2006

Last updated

Dec 23, 2019By 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

Michael Timothy Musolf, PARAMEDIC

Title

Fire Chief

Phone

(419) 855-4733

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577059200000",
    "number": "1891748893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21727",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441210727",
            "telephone_number": "440-605-9117",
            "fax_number": "440-442-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3155 N. GENOA CLAY CENTER RD",
            "city": "GENOA",
            "state": "OH",
            "postal_code": "434309464",
            "telephone_number": "419-855-4733",
            "fax_number": "419-855-1074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLEN CLAY JOINT FIRE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A",
        "authorized_official_last_name": "MUSOLF",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "TIMOTHY",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "419-855-4733",
        "authorized_official_credential": "PARAMEDIC"
    },
    "taxonomies": [
        {
            "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": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyse Marie Alexander, CNP
• Sara Marie Barr, PTA
• Bree Ann Bauerschmidt, OTR/L
• Amanda Lee Bergman
• Kelsey Buckley, MFN
• Amy Deverna

• Land Ambulance in Genoa, OH
• Providers in Genoa, OH by specialty
• Land Ambulance in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2019; 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.