Jefferson County Fire Protection District No 3

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

16D03 Issued in WA

Legal business name

JEFFERSON COUNTY FIRE PROTECTION DISTRICT NO 3

Doing business as

Port Ludlow Fire and Rescue

Practice address

7650 Oak Bay Rd
Port Ludlow, WA 98365-9634

Phone

(360) 437-2236

NPI assigned

Feb 10, 2006

Organization subpart

No

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

Authorized official

Name

Ed Wilkerson

Title

Fire Chief

Phone

(360) 437-2236

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Port Ludlow Fire and Rescue Doing business as

Locations

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315872000000",
    "number": "1548233372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3510",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983833510",
            "telephone_number": "360-394-7030",
            "fax_number": "360-394-7097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7650 OAK BAY RD",
            "city": "PORT LUDLOW",
            "state": "WA",
            "postal_code": "983659634",
            "telephone_number": "360-437-2236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON COUNTY FIRE PROTECTION DISTRICT NO 3",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-10",
        "last_updated": "2011-09-13",
        "status": "A",
        "authorized_official_last_name": "WILKERSON",
        "authorized_official_first_name": "ED",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "360-437-2236"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WA",
            "license": "16D03",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "590009805",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I AND CRIME VICTIMS",
            "identifier": "0036589",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9039462",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "JE0041",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Port Ludlow Fire and Rescue",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Land Ambulance in Port Ludlow, WA
• Providers in Port Ludlow, WA by specialty
• Land Ambulance in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; 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.