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OLD MYSTIC FIRE DEPARTMENT
NPI 1073981536
Emergency Medical Technician, Basic in Mystic, CT

Active since September 14, 2015CLIA 07D2114176 · Waiver
295 COW HILL RD, MYSTIC, CT 06355(860) 536-2220(860) 536-7811 Get Directions Write a Review

NPPES record last updated: September 14, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Old Mystic Fire Department NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OLD MYSTIC FIRE DEPARTMENT (NPI 1073981536) is a healthcare organization registered as an emergency medical technician, basic in Mystic, Connecticut and active in the NPI registry since September 2015. The organization holds a CLIA Waiver certificate valid through June 7, 2028 and lists Kenneth W. Richards, Fire Chief/fire Marshal, as its authorized official.

NPPES Registry Identity

NPI1073981536
Entity TypeOrganization
Primary Taxonomy146N00000X
Legal Business NameOLD MYSTIC FIRE DISTRICT
Location Address295 COW HILL RDMystic, CT 06355-1407
Mailing Address295 Cow Hill RdMystic, CT 06355-1407 · (860) 536-2220 · Fax (860) 536-7811
Phone(860) 536-2220
Fax(860) 536-7811
Organization SubpartNo
Authorized OfficialKenneth W. RichardsFire Chief/fire Marshal · (860) 536-2220
Enumeration DateSeptember 14, 2015
✔ NPI 1073981536 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency Medical Technician, BasicEmergency Medical Service Providers
Taxonomy Code146N00000X
Definition
A Basic EMT is an individual trained and certified to perform basic life support treatment in medical emergencies based on individual state boards.
295 COW HILL RD, Mystic, CT 06355
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Other Names 1

Other NameOld Mystic Fire Department

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 07D2114176

Old Mystic Fire Department · Mystic, CT
Active · expires Jun 7, 2028
CLIA Number07D2114176
Laboratory TypeFire Dept
Certificate Effective DateJune 8, 2026
Certificate Expiration DateJune 7, 2028
Laboratory DirectorKenneth W. Richards Jr
Laboratory Phone(860) 536-3432
Laboratory LocationOld Mystic Fire Department295 Cow Hill Rd, Mystic, CT 06355
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Old Mystic Fire District's NPI number?

The NPI number for Old Mystic Fire District is 1073981536. It was assigned to this organization in the NPPES registry on September 14, 2015. The provider is also known as Old Mystic Fire Department.

Where is Old Mystic Fire District located?

Old Mystic Fire District is located at 295 Cow Hill Rd, Mystic, CT 06355. The listed phone number is (860) 536-2220.

What is Old Mystic Fire District's specialty?

The primary specialty registered for this NPI is Emergency Medical Technician, Basic with taxonomy code 146N00000X.

Does Old Mystic Fire District hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 07D2114176) is associated with this NPI, valid through June 7, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Old Mystic Fire District was last updated on September 14, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.