Kootenai County Emergency Medical Services System

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

8146 Issued in ID

Legal business name

KOOTENAI COUNTY EMERGENCY MEDICAL SERVICES SYSTEM

Practice address

4381 W Seltice Way
Coeur D Alene, ID 83814-8910

Phone

(208) 930-4224

Fax

(208) 930-4259

NPI assigned

Aug 26, 2005

Last updated

Apr 8, 2024By 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

Tracy R Abrahamson

Title

Director of Finance

Phone

(208) 930-4224

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712534400000",
    "number": "1154314987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3510",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983833510",
            "telephone_number": "360-394-7020",
            "fax_number": "360-394-7099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4381 W SELTICE WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838148910",
            "telephone_number": "208-930-4224",
            "fax_number": "208-930-4259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOOTENAI COUNTY EMERGENCY MEDICAL SERVICES SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-26",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A",
        "authorized_official_last_name": "ABRAHAMSON",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "208-930-4224"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "ID",
            "license": "8146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "610071400",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805416900",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "590013218",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "136705",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9048224",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "299900",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Lewis Kominsky, MD
• Natalie D. Koncz, PA-C
• Angela Meghan Konegni, MS, RD, CSR, LD
• Carol Ann Kontos, PT
• Kootenai Audiology, LLC
• Kootenai Dental Group, LLC
• Kootenai Family Dental PLLC
• Kootenai Family Dental, PA
• Kootenai Health, Inc. (Kootenai Clinics Cancer Services Pharmacy)
• Kootenai Health, Inc.

• Land Ambulance in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Land Ambulance in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; 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.