North Douglas County Fire and EMS

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

0006-06 Issued in OR

Legal business name

NORTH DOUGLAS COUNTY FIRE AND EMS

Practice address

531 S Cedar St.
Drain, OR 97435

Phone

(541) 836-2282

Fax

(541) 836-2292

NPI assigned

Dec 8, 2006

Organization subpart

No

Name

Robert M Shannon

Title

Chief

Phone

(541) 836-2282

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 4, 2013.

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359936000000",
    "number": "1073672747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277",
            "city": "DRAIN",
            "state": "OR",
            "postal_code": "974350277",
            "telephone_number": "541-836-2282",
            "fax_number": "541-836-2292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 S CEDAR ST.",
            "city": "DRAIN",
            "state": "OR",
            "postal_code": "97435",
            "telephone_number": "541-836-2282",
            "fax_number": "541-836-2292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH DOUGLAS COUNTY FIRE AND EMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2013-02-04",
        "status": "A",
        "authorized_official_last_name": "SHANNON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "541-836-2282"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OR",
            "license": "0006-06",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135546",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "013427000",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "590010959",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joanne Marie Holland, M.D.
• Jacob Thomas Huegel, MD
• Corrinne Nicole Kaleese
• Zeah Katz, LMT
• Myndee Ferrill Counseling
• Umpqua Community Health Center, Inc.

• All providers in Drain, OR
• Land Ambulance in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2013; 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.

Verify at the official NPI Registry.