Active NPI
Amy Jean Lake
- Intermediate Emergency Medical Technician
- Winnemucca, NV
National Provider Identifier
1265098511
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intermediate Emergency Medical Technician
- License
- 76256
- Practice address
- 118 E Haskell St
Winnemucca, NV 89445-3247 - Phone
- (775) 623-5222
- NPI assigned
- May 13, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intermediate Emergency Medical Technician | 146M00000X | 76256 | NV | Primary |
Addresses
Primary practice location
118 E Haskell St
Winnemucca, NV 89445-3247
Mailing address
118 E Haskell St
Winnemucca, NV 89445-3247
Phone (775) 623-5222
Other practice location 1
118 E Haskell St
Winnemucca, NV 89445-3247
Phone (775) 623-5222
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 76256 | NV | MD | Intermediate Emergency Medical Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557705600000",
"number": "1265098511",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "118 E HASKELL ST",
"city": "WINNEMUCCA",
"state": "NV",
"postal_code": "894453247",
"telephone_number": "775-623-5222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "118 E HASKELL ST",
"city": "WINNEMUCCA",
"state": "NV",
"postal_code": "894453247",
"telephone_number": "775-623-5222"
}
],
"practiceLocations": [
{
"address_1": "118 E Haskell St",
"address_purpose": "LOCATION",
"city": "Winnemucca",
"state": "NV",
"postal_code": "894453247",
"country_code": "US",
"telephone_number": "775-623-5222",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LAKE",
"first_name": "AMY",
"middle_name": "JEAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-13",
"last_updated": "2019-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "146M00000X",
"taxonomy_group": "",
"desc": "Emergency Medical Technician, Intermediate",
"state": "NV",
"license": "76256",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winnemucca, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.