Jordan Valley Emergency Medical Service Authority

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

JORDAN VALLEY EMERGENCY MEDICAL SERVICE AUTHORITY

Practice address

555 Maple St
East Jordan, MI 49727-9778

Phone

(231) 536-7881

Fax

(231) 308-6440

NPI assigned

Jan 23, 2015

Last updated

Oct 22, 2018By 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

Gerald J Peck

Title

EMS Director

Phone

(231) 536-7881

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

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

{
    "created_epoch": "1421971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540166400000",
    "number": "1215327648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920",
            "city": "EAST JORDAN",
            "state": "MI",
            "postal_code": "497270920",
            "telephone_number": "231-536-7881",
            "fax_number": "231-308-6440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 MAPLE ST",
            "city": "EAST JORDAN",
            "state": "MI",
            "postal_code": "497279778",
            "telephone_number": "231-536-7881",
            "fax_number": "231-308-6440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JORDAN VALLEY EMERGENCY MEDICAL SERVICE AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-23",
        "last_updated": "2018-10-22",
        "status": "A",
        "authorized_official_last_name": "PECK",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EMS DIRECTOR",
        "authorized_official_telephone_number": "231-536-7881"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesse Leigh Haines, PHARMD
• Sara Elizabeth Hall, DDS
• Brooke Hawley, LPC, NCC, CADC
• Kathleen Sue Hill, OTRL
• Richard Lewis Johnson Sr., DDS, MS
• Casey Keane, PT, DPT, AT, ATC
• Kevin King
• Laboratory Corporation of America
• Erika Kelly Lagumina
• Sasha Lash

• Land Ambulance in East Jordan, MI
• Providers in East Jordan, MI by specialty
• Land Ambulance in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; 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.