Jae'S Transportaion LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

BB237706C Issued in ID

Legal business name

JAE'S TRANSPORTAION LLC

Practice address

14310 Tara St
Caldwell, ID 83607-1431

Phone

(208) 577-1337

NPI assigned

Jun 17, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Justin M Kudlacz

Title

Owner

Phone

(208) 577-1337

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1466121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466121600000",
    "number": "1104276377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14310 TARA ST",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836071431",
            "telephone_number": "208-577-1337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14310 TARA ST",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836071431",
            "telephone_number": "208-577-1337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAE'S TRANSPORTAION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-17",
        "last_updated": "2016-06-17",
        "status": "A",
        "authorized_official_last_name": "KUDLACZ",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-577-1337",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "ID",
            "license": "BB237706C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Marie Jackson, LCPC
• Ashlee Jackson, RN
• Cara Jackson
• Holli Cheree Jackson, ATC, LMT, CES, PES
• Lyndell Jackson, LCPC
• Randy L James, M.D.
• Craig R Jamison, PAC
• Perry A. Jansen, M.D., MPH
• Brandon Jenkins
• Jami B Jenkins, ARNP

• Non-emergency Medical Transport (VAN) in Caldwell, ID
• Providers in Caldwell, ID by specialty
• Non-emergency Medical Transport (VAN) in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2016; 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.