County of Emmet

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

COUNTY OF EMMET

Practice address

200 Division St
Petoskey, MI 49770-2486

Phone

(231) 348-1701

Fax

(231) 348-0633

NPI assigned

Sep 5, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Martin J Krupa

Title

Administrator

Phone

(231) 348-1701

Specialties & licenses 1

Addresses

Other names 1

• Emmet County EMS Other name

Medicare fee-for-service enrollment

Enrolled in MI2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Emmet County Medical Care Facility

  • Skilled Nursing Facility
  • Harbor Springs, MI
  • NPI 1124025440

  Member Of

  NPD member

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Emmet County Medical Care Facility

  • Skilled Nursing Facility
  • Harbor Springs, MI
  • NPI 1124025440

  5% Or Greater Direct Ownership Interest, Adp of the SNF

  CMS ownership

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

{
    "created_epoch": "1409875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420502400000",
    "number": "1619378031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 DIVISION ST",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702486",
            "telephone_number": "231-348-1701",
            "fax_number": "231-348-0633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 DIVISION ST",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702486",
            "telephone_number": "231-348-1701",
            "fax_number": "231-348-0633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF EMMET",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-05",
        "last_updated": "2015-01-06",
        "status": "A",
        "authorized_official_last_name": "KRUPA",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "231-348-1701",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emmet County EMS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Carla Crockett, MS, OTRL

• Land Ambulance in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Land Ambulance in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.