County of Elmore

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

COUNTY OF ELMORE

Practice address

150 S 4TH E Ste 3
Mountain Home, ID 83647-3000

Phone

(208) 587-2133

Fax

(208) 587-2159

NPI assigned

Sep 8, 2017

Last updated

Oct 12, 2022By 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

Alysia Ann Alkire, CAC

Title

Billing Specialist

Phone

(208) 580-0413

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 3

• Elmore County Ambulance District Former legal business name
• Elmore County Ambulance Other name
• Pine Featherville EMS Other name

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

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

{
    "created_epoch": "1504828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665532800000",
    "number": "1316465453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 S 4TH E STE 3",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836473000",
            "telephone_number": "208-587-2129",
            "fax_number": "208-587-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S 4TH E STE 3",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836473000",
            "telephone_number": "208-587-2133",
            "fax_number": "208-587-2159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2259 E. 8th N.",
            "address_purpose": "LOCATION",
            "city": "Mountain Home",
            "state": "ID",
            "postal_code": "836478364",
            "country_code": "US",
            "telephone_number": "208-580-0413 x1014",
            "fax_number": "208-580-9450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COUNTY OF ELMORE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-08",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A",
        "authorized_official_last_name": "ALKIRE",
        "authorized_official_first_name": "ALYSIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "BILLING SPECIALIST",
        "authorized_official_telephone_number": "208-580-0413",
        "authorized_official_credential": "CAC"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AGENCY LICENSE",
            "identifier": "10020",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7511",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elmore County Ambulance District",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Elmore County Ambulance District",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Elmore County Ambulance",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Pine Featherville EMS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Reysan R Cotton, LPC
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• Jessica Cristobal, MS, CCC-SLP
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• Land Ambulance in Mountain Home, ID
• Providers in Mountain Home, ID by specialty
• Land Ambulance in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; 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.