Six Forks Rescue Squad, Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1220 Issued in NC

Legal business name

SIX FORKS RESCUE SQUAD, INC.

Practice address

1431 Lynn Rd
Raleigh, NC 27612-2427

Phone

(919) 848-8999

Fax

(919) 847-9721

NPI assigned

Oct 28, 2005

Organization subpart

No

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

Authorized official

Name

Thomas B Jeffries

Title

Chief

Phone

(919) 848-8999

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1992795017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863",
            "city": "LEWISVILLE",
            "state": "NC",
            "postal_code": "270230863",
            "telephone_number": "800-814-5339",
            "fax_number": "336-766-1279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 LYNN RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276122427",
            "telephone_number": "919-848-8999",
            "fax_number": "919-847-9721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIX FORKS RESCUE SQUAD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-28",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "JEFFRIES",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "919-848-8999"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NC",
            "license": "1220",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NC",
            "license": "1220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3406790",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "07288",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.