NPIMap

Organization Active NPI

Leadore Emergency Medical Technicians, Inc.

  • Ambulance
  • Leadore, ID
National Provider Identifier
1205925435
Registry record updated Jun 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
5706 Issued in ID
Legal business name
LEADORE EMERGENCY MEDICAL TECHNICIANS, INC.
Practice address
117 Galena St.
Leadore, ID 83464-0051
Phone
(208) 768-2426
Fax
(208) 768-2426
NPI assigned
Oct 12, 2006
Last updated
Jun 9, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2009

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

Authorized official

Name
Mr. Richard Snyder
Title
President
Phone
(208) 768-2714

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 5706 ID Primary

Addresses

Primary practice location

117 Galena St.
Leadore, ID 83464-0051

Mailing address

PO Box 51
Leadore, ID 83464-0051
Phone (208) 768-2426

Other identifiers 5

IdentifierTypeStateIssuer
002494700MedicaidID
200070010AMedicaidOK
0442323MedicaidMT
E0682OtherIDBLUE CROSS OF IDAHO
000010033120OtherIDREGENCE BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090717000535 ID Part B Supplier - Ambulance Service Supplier 0042362279 Practice locations: Leadore, ID

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
13D2212269Leadore Emergency Medical Technicians Inc117 Galena St, Leadore, ID 83464Certificate of waiverFeb 2, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244505600000",
    "number": "1205925435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51",
            "city": "LEADORE",
            "state": "ID",
            "postal_code": "834640051",
            "telephone_number": "208-768-2426",
            "fax_number": "208-768-2426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 GALENA ST.",
            "city": "LEADORE",
            "state": "ID",
            "postal_code": "834640051",
            "telephone_number": "208-768-2426",
            "fax_number": "208-768-2426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEADORE EMERGENCY MEDICAL TECHNICIANS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2009-06-09",
        "status": "A",
        "authorized_official_last_name": "SNYDER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-768-2714",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "ID",
            "license": "5706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002494700",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200070010A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0442323",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "E0682",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "000010033120",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leadore, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2009; 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.