Organization Active NPI

Forreston Fire Protection District

  • Land Ambulance
  • Forreston, IL
National Provider Identifier
1992824924
Registry record updated Jun 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
1369688 Issued in IL
Legal business name
FORRESTON FIRE PROTECTION DISTRICT
Practice address
301 E. Main Street
Forreston, IL 61030-0212
Phone
(815) 938-2345
NPI assigned
Mar 29, 2007
Last updated
Jun 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2012

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

Authorized official

Name
Mr. Jack Royce Daws
Title
President of Board
Phone
(815) 262-3531

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 1369688 IL Primary

Addresses

Primary practice location

301 E. Main Street
Forreston, IL 61030-0212

Mailing address

P.O. Box 260
Mendota, IL 61342-0260
Phone (815) 539-2468

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091209000139 IL Part B Supplier - Ambulance Service Supplier 1355480070 Practice locations: Forreston, IL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339977600000",
    "number": "1992824924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 260",
            "city": "MENDOTA",
            "state": "IL",
            "postal_code": "613420260",
            "telephone_number": "815-539-2468",
            "fax_number": "815-539-6427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E. MAIN STREET",
            "city": "FORRESTON",
            "state": "IL",
            "postal_code": "610300212",
            "telephone_number": "815-938-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORRESTON FIRE PROTECTION DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2012-06-18",
        "status": "A",
        "authorized_official_last_name": "DAWS",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "ROYCE",
        "authorized_official_title_or_position": "PRESIDENT OF BOARD",
        "authorized_official_telephone_number": "815-262-3531",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "1369688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forreston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2012; 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.