City of Fredericksburg

Primary specialty

AmbulanceTaxonomy code 341600000X

License

511 Issued in VA

Legal business name

CITY OF FREDERICKSBURG

Practice address

601 Princess Anne St
Fredericksburg, VA 22401-5914

Phone

(540) 372-1059

Fax

(540) 372-1050

NPI assigned

Nov 17, 2006

Organization subpart

No

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

Authorized official

Name

Matthew Fox Jr.

Title

Deputy Chief

Phone

(540) 372-1059

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Fredericksburg Fire Department Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636329600000",
    "number": "1972676799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2605",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245516605",
            "telephone_number": "866-631-4452",
            "fax_number": "937-291-2971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 PRINCESS ANNE ST",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224015914",
            "telephone_number": "540-372-1059",
            "fax_number": "540-372-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF FREDERICKSBURG",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "DEPUTY CHIEF",
        "authorized_official_telephone_number": "540-372-1059",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "VA",
            "license": "511",
            "primary": true
        },
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "VA",
            "license": "511",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "338899",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00641039",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fredericksburg Fire Department",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fredericksburg Fire Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nareg Sam Churukian, DO
• Robert John Ciccone, DDS
• Elizabeth Ciciarelli
• Charles Michael Cifizzari
• Marissa Citarelli
• Sarah Morris Clanton, RIC
• Brenda Clark
• Brychan K.M. Clark, M.D.
• Christopher Paul Clark, DPT
• Heidi Clark

• Ambulance in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Ambulance in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.