Riverside Fire Authority

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

RIVERSIDE FIRE AUTHORITY

Practice address

1818 Harrison Ave
Centralia, WA 98531-1905

Phone

(360) 736-3975

Fax

(360) 330-5573

NPI assigned

Dec 3, 2018

Organization subpart

No

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

Authorized official

Name

Michael Steven Kytta

Title

Fire Chief

Phone

(360) 736-3975

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jason Nathaniel Shepherd, PA-C

  • Physician Assistant
  • Centralia, WA
  • NPI 1598112054
  NPD (past)

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

{
    "created_epoch": "1543795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543795200000",
    "number": "1972073963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 HARRISON AVE",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985311905",
            "telephone_number": "360-736-3975",
            "fax_number": "360-330-5573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 HARRISON AVE",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985311905",
            "telephone_number": "360-736-3975",
            "fax_number": "360-330-5573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE FIRE AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-03",
        "last_updated": "2018-12-03",
        "status": "A",
        "authorized_official_last_name": "KYTTA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "360-736-3975"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUSINESS LICENSE",
            "identifier": "601138655",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Kelly Rigg, MPT
• Jocelyn Renee Rine
• Timothy Eric Rise
• Tera Risenhoover, BA, AAC
• Tanya Risley
• Riverside Nursing - Centralia LLC
• Riverside Nursing - Centralia LLC
• Alejandra Maria Robbins
• Ona C Robbins, RN
• Brian David Roberts, D.D.S.

• Land Ambulance in Centralia, WA
• Providers in Centralia, WA by specialty
• Land Ambulance in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; 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.