Covelo Ambulance Service

Primary specialty

AmbulanceTaxonomy code 341600000X

Legal business name

COVELO AMBULANCE SERVICE

Practice address

79500 Covelo Rd
Covelo, CA 95428

Phone

(707) 272-3099

NPI assigned

Apr 17, 2007

Organization subpart

No

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

Authorized official

Name

William Baker

Title

Fire Chief

Phone

(707) 272-3099

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192665600000",
    "number": "1174748784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 36",
            "city": "COVELO",
            "state": "CA",
            "postal_code": "954280036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79500 COVELO RD",
            "city": "COVELO",
            "state": "CA",
            "postal_code": "95428",
            "telephone_number": "707-272-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVELO AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-10-18",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "707-272-3099"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRB",
            "identifier": "P00020014",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ37505Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laurence Richard Alavezos, M.D.
• Carol Appel-Basham, P.A
• Dasiana Champagne
• Maria V Danilychev, M.D.
• Craig B Emerson, DDS
• Rose Margarette Johnson, DENTAL HYGIENIST
• Stephen Archie Johnson, RN, NP ,PA
• Sarah Kagin

• All providers in Covelo, CA
• Ambulance in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; 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.