Crescent Rural Fire Protection District

Primary specialty

AmbulanceTaxonomy code 341600000X

License

1830 Issued in OR

Legal business name

CRESCENT RURAL FIRE PROTECTION DISTRICT

Practice address

150 Mountain View Dr
Gilchrist, OR 97737-3244

Phone

(541) 433-2466

Fax

(541) 433-2600

NPI assigned

Oct 13, 2006

Last updated

Oct 10, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert Lewis Petersen

Title

President, Board of Directors

Phone

(541) 433-2466

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539129600000",
    "number": "1073603528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 811",
            "city": "GILCHRIST",
            "state": "OR",
            "postal_code": "977370811",
            "telephone_number": "541-433-2466",
            "fax_number": "541-433-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MOUNTAIN VIEW DR",
            "city": "GILCHRIST",
            "state": "OR",
            "postal_code": "977373244",
            "telephone_number": "541-433-2466",
            "fax_number": "541-433-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESCENT RURAL FIRE PROTECTION DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2018-10-10",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LEWIS",
        "authorized_official_title_or_position": "PRESIDENT, BOARD OF DIRECTORS",
        "authorized_official_telephone_number": "541-433-2466"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "OR",
            "license": "1830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171017",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50220",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1073603528",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800382",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• La Pine Community Health Center

• Ambulance in Gilchrist, OR
• Providers in Gilchrist, OR by specialty
• Ambulance in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2018; 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.