City of Kooskia

Primary specialty

AmbulanceTaxonomy code 341600000X

License

7215 Issued in ID

Legal business name

CITY OF KOOSKIA

Doing business as

Kooskia Ambulance

Practice address

001 4TH Ave
Kooskia, ID 83539

Phone

(208) 926-0172

NPI assigned

Apr 16, 2007

Last updated

Dec 11, 2015By 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

Wendy Diane Engbrecht

Title

Secretary/Treasurer

Phone

(208) 926-4858

Specialties & licenses 1

Addresses

Other names 1

• Kooskia Ambulance Doing business as

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449792000000",
    "number": "1114142833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 339",
            "city": "KOOSKIA",
            "state": "ID",
            "postal_code": "835390339",
            "telephone_number": "208-926-4858",
            "fax_number": "208-926-4858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "001 4TH AVE",
            "city": "KOOSKIA",
            "state": "ID",
            "postal_code": "83539",
            "telephone_number": "208-926-0172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF KOOSKIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2015-12-11",
        "status": "A",
        "authorized_official_last_name": "ENGBRECHT",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "SECRETARY/TREASURER",
        "authorized_official_telephone_number": "208-926-4858"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "ID",
            "license": "7215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kooskia Ambulance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clearwater Valley School District #245
• Kiley Johnson
• Syringa General Hospital District C I F (Syringa Kooskia Clinic)

• Ambulance in Kooskia, ID
• Providers in Kooskia, ID by specialty
• Ambulance in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2015; 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.