Mid Valley Ambulance Service Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

3639 Issued in OR

Legal business name

MID VALLEY AMBULANCE SERVICE INC.

Practice address

280 Jefferson St
Eugene, OR 97402-5027

Phone

(541) 747-4025

NPI assigned

Aug 6, 2018

Organization subpart

No

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

Authorized official

Name

JD Fuiten

Title

Owner

Phone

(541) 648-6658

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1533513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707955200000",
    "number": "1104304682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 OCEAN BLVD SE",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974203537",
            "telephone_number": "541-266-4300",
            "fax_number": "541-267-0831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 JEFFERSON ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974025027",
            "telephone_number": "541-747-4025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID VALLEY AMBULANCE SERVICE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-06",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A",
        "authorized_official_last_name": "FUITEN",
        "authorized_official_first_name": "JD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-648-6658"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OR",
            "license": "3639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Michaels, PHD
• Michael Michel
• Misti R Micheletto, B.ED.
• Jordan L Michels, D.C.
• Lee G Michels, MD
• Middle Fork Surgery Center LLC
• Megan Danielle Middlekauff, LCSW
• Midwest Care Angelwood, LLC
• Midwifery Care
• Cosmin Marius Mihalcea, LMT

• Land Ambulance in Eugene, OR
• Providers in Eugene, OR by specialty
• Land Ambulance in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; 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.