Breathitt-Wolfe EMS Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

BREATHITT-WOLFE EMS INC

Practice address

3 Howell LN
Jackson, KY 41339-8657

Phone

(606) 666-4444

NPI assigned

May 6, 2019

Last updated

May 14, 2019By 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

Jarred Fannin

Title

Owner

Phone

(606) 548-0960

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557792000000",
    "number": "1104481092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 589",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424315011",
            "telephone_number": "270-824-8123",
            "fax_number": "270-824-8140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 HOWELL LN",
            "city": "JACKSON",
            "state": "KY",
            "postal_code": "413398657",
            "telephone_number": "606-666-4444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "167 Wolfe Co Elementary School Rd",
            "address_purpose": "LOCATION",
            "city": "Campton",
            "state": "KY",
            "postal_code": "413016528",
            "country_code": "US",
            "telephone_number": "606-668-9111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BREATHITT-WOLFE EMS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-06",
        "last_updated": "2019-05-14",
        "status": "A",
        "authorized_official_last_name": "FANNIN",
        "authorized_official_first_name": "JARRED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-548-0960"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breathitt County Health Department (Breathitt County Home Health)
• Breathitt County Health Department
• Breathitt County Home Medical LLC
• Breathitt Dental Clinic PSC
• Breathitt Emergency Group, LLC
• Breatitt County Geriatric Corporation (nim henson geriatric center)
• Bobby Brewer Jr.
• Carol Bryant Jones, LPCA
• Kristin Burge
• George Edward Burnette, MD

• Land Ambulance in Jackson, KY
• Providers in Jackson, KY by specialty
• Land Ambulance in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2019; 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.