Northwest Medical Transport LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

NORTHWEST MEDICAL TRANSPORT LLC

Practice address

1726 W Depo Dr
Hayden, ID 83835-8025

Phone

(208) 665-5671

NPI assigned

Apr 27, 2016

Organization subpart

No

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

Authorized official

Name

Janiece Lake

Title

Owner

Phone

(208) 665-5671

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778025600000",
    "number": "1245685239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1726 W DEPO DR",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838358025",
            "telephone_number": "208-665-5671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1726 W DEPO DR",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838358025",
            "telephone_number": "208-665-5671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST MEDICAL TRANSPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-27",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A",
        "authorized_official_last_name": "LAKE",
        "authorized_official_first_name": "JANIECE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-665-5671"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "M8077266",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Hayden, ID
• Providers in Hayden, ID by specialty
• Non-emergency Medical Transport (VAN) in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.