Organization Active NPI

Justin Community Volunteer Fire Department Inc.

  • Ambulance
  • Justin, TX
National Provider Identifier
1891795886
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
061017 Issued in TX
Legal business name
JUSTIN COMMUNITY VOLUNTEER FIRE DEPARTMENT INC.
Practice address
304 N Sealy Ave
Justin, TX 76247-9458
Phone
(940) 648-2561
Fax
(940) 648-2561
NPI assigned
Jul 30, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Robert Wilson Stubblefield
Title
EMS Chief
Phone
(940) 367-0827

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 061017 TX Primary

Addresses

Primary practice location

304 N Sealy Ave
Justin, TX 76247-9458

Mailing address

PO Box 613
Justin, TX 76247-0613
Phone (940) 648-2561

Other identifiers 1

IdentifierTypeStateIssuer
AOAMB1174MedicaidTX

Other names 1

  • Justin Fire Department Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1030400Justin Community Volunteer Fire Dept304 N Sealy, Justin, TX 76247Certificate of waiverSep 2, 2026

National Provider Directory

National Provider Directory
Tax ID family
Justin Vol Fire Dept2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

304 N Sealy Ave
Justin, TX 76247
Phone (940) 648-2561

NPI Registry JSON

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

{
    "created_epoch": "1122681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891795886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 613",
            "city": "JUSTIN",
            "state": "TX",
            "postal_code": "762470613",
            "telephone_number": "940-648-2561",
            "fax_number": "940-648-2561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 N SEALY AVE",
            "city": "JUSTIN",
            "state": "TX",
            "postal_code": "762479458",
            "telephone_number": "940-648-2561",
            "fax_number": "940-648-2561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTIN COMMUNITY VOLUNTEER FIRE DEPARTMENT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STUBBLEFIELD",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "WILSON",
        "authorized_official_title_or_position": "EMS CHIEF",
        "authorized_official_telephone_number": "940-367-0827",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "TX",
            "license": "061017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AOAMB1174",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Justin Fire Department",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Justin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.