Active NPI
Paisley Disaster Unit
- Ambulance
- Paisley, OR
National Provider Identifier
1053480806
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulance
- License
- E179847
- Legal business name
- PAISLEY DISASTER UNIT
- Practice address
- 1011 Cottonwood
Paisley, OR 97636 - Phone
- (541) 882-6984
- NPI assigned
- Nov 7, 2006
- Last updated
- May 15, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Pierre Hoppe
- Title
- Secretary/Treasurer
- Phone
- (541) 419-4012
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | E179847 | OR | Primary |
Addresses
Primary practice location
1011 Cottonwood
Paisley, OR 97636
Mailing address
PO Box 208
Paisley, OR 97636-0208
Phone (541) 419-4012
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 278646 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070618000017 | OR | Part B Supplier - Ambulance Service Supplier | 9133228109 | Practice locations: Paisley, OR |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 38D0995852 | Paisley Disaster Unit | Certificate of waiver | Jan 31, 2028 |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1526342400000",
"number": "1053480806",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 208",
"city": "PAISLEY",
"state": "OR",
"postal_code": "976360208",
"telephone_number": "541-419-4012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1011 COTTONWOOD",
"city": "PAISLEY",
"state": "OR",
"postal_code": "97636",
"telephone_number": "541-882-6984"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PAISLEY DISASTER UNIT",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-07",
"last_updated": "2018-05-15",
"status": "A",
"authorized_official_last_name": "HOPPE",
"authorized_official_first_name": "PIERRE",
"authorized_official_title_or_position": "SECRETARY/TREASURER",
"authorized_official_telephone_number": "541-419-4012"
},
"taxonomies": [
{
"code": "341600000X",
"taxonomy_group": "",
"desc": "Ambulance",
"state": "OR",
"license": "E179847",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "278646",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Paisley, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.