Texas Fire Chiefs Association DOCUMENT SUBMISSION FORM. Coppell Fire Department
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1 1 Texas Fire Chiefs Association DOCUMENT SUBMISSION FORM Candidate Department: Coppell Fire Department Best Practice Standard:2.03 EMS Provider (insert the Best Practice Standard you are working on - example 1.01 ) Proofs of Compliance Submitted: 1. DSHS EMS Provider Letter of Continuance (Page 3). 2. Texas DSHS EMS Renewal Packet (Pages 3-27). 3. Copy of organization s current members licensed to provide EMS services by DSHS (28-33). Submitted By: Gregg Loyd Date: 10/1/2013 Evaluator s Review Evaluator: Date Accepted:
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28 28 Coppell Fire Department Personnel Credentials Last Name First Name Status Employee Number Credential Credential Number Current Date Expiration Date ADAMS JOHN Active 325 EMT-Paramedic /21/ /31/2014 ADDISON BLAINE Active ADDISON CHRISTOPHER Active ALLEN TIM Active BAIRD JAMES Active BARTOLACCI BARRY Active BAZE TAYLOR Active BEARE JAMES Active 1243 BEYER GARY Active 941 BOURLAND TODD Active BOYLES BRANDON Active 1508 BREWSTER JAMES Active Briggs Shane Active BROOM JEREMY Active BROWER MICHAEL Active 2159 BURR KELLEY Active 734 NREMT-Paramedic (NREMT-P) P /02/ /31/2014 EMT-Paramedic /31/ /31/2016 EMT-Paramedic /30/ /30/2015 EMT-Paramedic /21/ /31/2017 EMT-Paramedic /30/ /30/2017 EMT-Paramedic /23/ /31/2017 EMT-Paramedic /23/ /30/2016 EMT-Paramedic /23/ /31/2017 NREMT-Paramedic (NREMT-P) p /26/ /31/2013 EMT-Paramedic /20/ /31/2017 FLIGHT PARAMEDIC /19/ /30/2015 NREMT-Paramedic (NREMT-P) P /21/ /31/2014 EMT-Paramedic /23/ /31/2015 EMT-Paramedic /23/ /31/2017 NREMT-Paramedic (NREMT-P) p /27/ /31/2014 EMT-Paramedic /23/ /30/2017 EMT-Paramedic 03/23/2011 EMT-Paramedic /23/ /31/2016 EMT-Paramedic /31/ /31/2015 CRITICAL CARE PARAMEDIC /28/ /30/2014 EMT-Paramedic /23/ /30/2014
29 Last Name First Name Status Employee Number Credential Credential Number Current Date Expiration Date 29 BURRIS STUART Active EMT-Paramedic /23/ /31/2016 CAMPBELL ADAM Active 1725 EMT-Paramedic /23/ /31/2016 NREMT-Paramedic (NREMT-P) p /27/ /31/2013 CARTER CHARLES Active 1007 EMT-Paramedic /23/ /31/2015 NREMT-Paramedic (NREMT-P) P /28/ /31/2014 CHITWOOD CHASE Active 2154 CODY MICHAEL Active CROUCH EDWARD Active DABBS JOHN Active 1025 DAILEY JAMES Active 1315 DANIELS MARK Active DEAN JARROD Active 1622 DINGFIELD HEATHER Active ELLIOTT MARK Active 0363 FISK ROBERT Active 1623 FOSTER JOHN Active GREASER ERIC Active GREEN DAVID Active GREENBERG BRANDON Active 1695 EMT-Paramedic /23/ /31/2017 FLIGHT PARAMEDIC /21/ /15/2015 NREMT-Paramedic (NREMT-P) p /21/ /31/2015 EMT-Paramedic /23/ /23/2015 EMT-Paramedic /31/ /31/2017 NREMT-Paramedic (NREMT-P) P /27/ /31/2014 EMT-Paramedic /23/ /31/2016 EMT-Paramedic /23/ /31/2016 NREMT-Paramedic (NREMT-P) p /28/ /31/2013 EMT-Paramedic /23/ /23/2015 EMT-Paramedic /23/ /31/2015 NREMT-Paramedic (NREMT-P) /21/ /31/2013 FLIGHT PARAMEDIC /21/ /31/2015 EMT-Paramedic /23/ /31/2017 EMT-Paramedic /23/ /31/2016 EMT-Paramedic /23/ /31/2016 EMT-Basic /15/ /30/2017 EMT-Paramedic 03/23/2011 EMT-Paramedic /23/ /23/2015 EMT-Paramedic /23/ /31/2015 NREMT-Paramedic (NREMT-P) P /21/ /31/2015
30 Last Name First Name Status Employee Number Credential Credential Number Current Date Expiration Date 30 CRITICAL CARE PARAMEDIC /21/ /30/2014 FLIGHT PARAMEDIC /21/ /30/2014 HAMILTON JOHN Active 1927 HARDIN CHAD Active 1502 HARDT BRAD Active INMAN JASON Active JOLES EVERETT Active JONES BRANDON Active 2049 KINNEY KERRY Active KNIGHT JOHN Active LEE AUSTIN Active LEECH CHRIS Active LOVELL DURL Active LOYD GREGG Active 2034 MCCRACKEN AUSTIN Active 2298 MCDOWELL MICHAEL Active MCGEE ROBERT Active MCINIS WILLIE Active 007 NREMT-Paramedic (NREMT-P) p /27/ /31/2014 EMT-Paramedic /27/ /31/2012 FLIGHT PARAMEDIC /21/ /28/2015 NREMT-Paramedic (NREMT-P) /21/ /31/2014 EMT-Paramedic /23/ /30/2017 EMT-Paramedic /23/ /31/2013 EMT-Paramedic /23/ /23/2015 EMT-Paramedic /23/ /23/2017 NREMT-Paramedic (NREMT-P) P /02/ /31/2014 EMT-Paramedic /27/ /31/2014 NREMT-Paramedic (NREMT-P) p /27/ /31/2014 EMT-Paramedic /23/ /31/2015 EMT-Paramedic /23/ /23/2015 FLIGHT PARAMEDIC /31/ /31/2017 NREMT-Paramedic (NREMT-P) P /31/ /31/2015 EMT-Paramedic /31/ /31/2016 EMT-Paramedic /23/ /23/2015 NREMT-Paramedic (NREMT-P) P /31/ /31/2014 EMT-Paramedic /23/ /29/2016 EMT-Paramedic /30/ /30/2016 EMT-Paramedic /31/ /31/2016 EMT-Paramedic /23/ /23/2015 EMT-Paramedic /23/ /31/2015
31 Last Name First Name Status Employee Number Credential Credential Number Current Date Expiration Date 31 MILLER CODY Active 2051 MOON MONTY Active 484 MUSSER GARRETT Active EMT-Basic /23/ /30/2017 EMT-Paramedic /31/ /31/2017 EMT-Paramedic /23/ /31/2017 CRITICAL CARE PARAMEDIC /21/ /30/2014 EMT-Paramedic /31/ /31/2014 NICKELSON PRESTON Active 2161 OLSON BREA Active 2160 PACE JASON Active PARR JARRETT Active 561 PARSONS JON Active PAYNE TOMMY Active PIERCE BRIAN Active PIERCE JAMES Active 2297 PORTER ERIC Active 1077 PRICE MARLIN Active 1303 RICHARDSON TY Active RIDLING ROBERT Active 1141 RINARD JAMES Active RODRIGUEZ RENE Active EMT-Paramedic /18/ /30/2015 EMT-Paramedic /31/ /31/2016 FLIGHT PARAMEDIC /31/ /31/2017 EMT-Paramedic /23/ /23/2015 EMT-Paramedic /23/ /31/2016 EMT-Paramedic /23/ /28/2014 EMT-Paramedic /31/ /31/2017 EMT-Paramedic /23/ /31/2015 NREMT-Paramedic (NREMT-P) p /26/ /31/2013 EMT-Paramedic /30/ /30/2016 NREMT-Paramedic (NREMT-P) p /26/ /31/2013 EMT-Paramedic /23/ /31/2015 EMT-Paramedic /23/ /31/2015 CRITICAL CARE PARAMEDIC /21/ /30/2014 NREMT-Paramedic (NREMT-P) /21/ /31/2014 EMT-Paramedic /23/ /31/2016 EMT-Paramedic /27/ /31/2015 NREMT-Paramedic (NREMT-P) p /23/ /31/2014 NREMT-Paramedic (NREMT-P) p /31/ /31/2014 EMT-Paramedic /23/ /23/2015
32 Last Name First Name Status Employee Number Credential Credential Number Current Date Expiration Date 32 EMT-Paramedic /23/ /31/2015 RUSSELL TIM Active 562 SMITH BRAD Active 1625 SPENCER RYAN Active 1497 STACY BRIAN Active 911 STONE ROBERT Active TAYLOR STEPHEN Active TAYLOR JAIME Active 2296 THOMASON SAM Active UPPOLE MATTHEW Active 370 WHITE BRYAN Active WHITE DAVID Active WILLIAMS ROBERT Active WILLIAMSON BLAKE Active 2153 WILSON MICHAEL Active 801 EMT-Paramedic /23/ /31/2016 EMT-Paramedic /23/ /31/2015 NREMT-Paramedic (NREMT-P) /21/ /31/2014 CRITICAL CARE PARAMEDIC /21/ /30/2014 FLIGHT PARAMEDIC /21/ /30/2014 CRITICAL CARE PARAMEDIC /21/ /30/2014 NREMT-Paramedic (NREMT-P) P /21/ /31/2014 Nurse /21/2012 FLIGHT PARAMEDIC /21/ /31/2016 EMT-Paramedic /23/ /31/2012 NREMT-Paramedic (NREMT-P) p /26/ /31/2013 EMT-Paramedic /23/ /31/2016 EMT-Paramedic /23/ /23/2015 EMT-Paramedic /31/ /31/2017 EMT-Paramedic /31/ /31/2015 EMT-Paramedic /23/ /23/2015 EMT-Paramedic /23/ /31/2015 EMT-Basic /23/ /31/2015 EMT-Paramedic /23/ /31/2017 EMT-Paramedic /30/ /30/2017 NREMT-Paramedic (NREMT-P) p /31/ /31/2015 NREMT-Paramedic (NREMT-P) P /26/ /31/2015 FLIGHT PARAMEDIC /01/ /30/2016 EMT-Paramedic /23/ /31/2012 EMT-Paramedic /23/ /31/2017
33 Last Name First Name Status Employee Number Credential Credential Number Current Date Expiration Date 33 FLIGHT PARAMEDIC /21/ /31/2015 WOLSKE JIMMY Active EMT-Paramedic /23/ /31/2014 YOWELL JON Active EMT-Paramedic /23/ /30/2016
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