Jjdac Inc.

Primary specialty

AmbulanceTaxonomy code 341600000X

License

51164 Issued in NM

Legal business name

JJDAC INC.

Practice address

511 Nizhoni Blvd
Gallup, NM 87301

Phone

(505) 722-5295

Fax

(505) 722-6426

NPI assigned

Dec 1, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Eric Thomas

Title

SVP of Revenue Management

Phone

(877) 288-5340

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Med Star Ambulance Doing business as

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Jjdac, LLC

  • Land Ambulance
  • Gallup, NM
  • NPI 1922514686
  NPPES parent name

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533254400000",
    "number": "1093883787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 610",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873050511",
            "telephone_number": "505-722-5295",
            "fax_number": "505-722-6426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 NIZHONI BLVD",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "87301",
            "telephone_number": "505-722-5295",
            "fax_number": "505-722-6426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JJDAC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2018-08-03",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "SVP OF REVENUE MANAGEMENT",
        "authorized_official_telephone_number": "877-288-5340",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NM",
            "license": "51164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "R3562",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Med Star Ambulance",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Med Star Ambulance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Courtney Jeffreys, RN
• Debra Jenkins, RN
• Jacob Jennings, DDS
• Leroy Jim, LPCC, CRC
• Debora Jimenez, RN
• Jjdac, LLC
• Kasha K John
• Michelle John
• Vera D John, LPCC
• Eugenia M Johns, RN

• Ambulance in Gallup, NM
• Providers in Gallup, NM by specialty
• Ambulance in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.