Village of Medina

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

3615 Issued in NY

Legal business name

VILLAGE OF MEDINA

Practice address

600 Main St
Medina, NY 14103-1577

Phone

(585) 768-2192

Fax

(585) 768-7323

NPI assigned

Feb 28, 2006

Last updated

Apr 20, 2022By 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

Matthew Jackson

Title

Fire Chief

Phone

(585) 798-1661

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650412800000",
    "number": "1962478800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 186",
            "city": "LE ROY",
            "state": "NY",
            "postal_code": "144820186",
            "telephone_number": "585-768-2192",
            "fax_number": "585-768-7323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MAIN ST",
            "city": "MEDINA",
            "state": "NY",
            "postal_code": "141031577",
            "telephone_number": "585-768-2192",
            "fax_number": "585-768-7323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF MEDINA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-28",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "585-798-1661"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NY",
            "license": "3615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01367179",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rei Thomas
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• TND Physical Therapy P.C. (Park Avenue Physical Therapy)
• Tops Markets LLC (Tops Pharmacy)
• Kit Trapasso, MS
• Walgreen Co (Walgreens #18251)
• Shantanette S Warren, LPN
• Fatima Maria Westgate, LMHC
• Melinda Renee Williams, PHARMD
• Carrie Ann Wilson, OTR/L

• Land Ambulance in Medina, NY
• Providers in Medina, NY by specialty
• Land Ambulance in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; 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.