NPIMap

Organization Active NPI

County of Washington

Doing business as Washington County Ambulance Service

  • Ambulance
  • Washington, IA
National Provider Identifier
1619507415
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
Legal business name
COUNTY OF WASHINGTON
Doing business as
Washington County Ambulance Service
Practice address
1120 N 8TH Ave
Washington, IA 52353-2618
Phone
(319) 653-2047
Fax
(319) 653-3344
NPI assigned
Jan 21, 2020
Last updated
Aug 5, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
WASHINGTON COUNTY AMBULANCE SERVICEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 5, 2020

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

Authorized official

Name
Jeremy Arthur Peck, PARAMEDIC
Title
Ambulance Director
Phone
(319) 653-2047

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X NU Primary

Addresses

Primary practice location

1120 N 8TH Ave
Washington, IA 52353-2618

Mailing address

PO Box 889
Washington, IA 52353-0889
Phone (319) 653-2047

Other names 1

  • Washington County Ambulance Service Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200805001204 IA Part B Supplier - Ambulance Service Supplier 9638142151 Practice locations: Kalona, IA; Washington, IA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
County of Washington4 organizations share this tax ID, including this one
Part of
County of Washington

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

107 N Avenue B
Washington, IA 52353

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Washington County Public Health and Home CareWashington, IA, CCN 167109 Home health agency 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1990

Owned or controlled facilities with NPI records 1

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

  • County of Washington

    dba Washington County Public Health and Home Care

    • Home Health Agency
    • Washington, IA
    • NPI 1932194107

    5% Or Greater Direct Ownership Interest

    CMS ownership

NPI Registry JSON

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

{
    "created_epoch": "1579564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596585600000",
    "number": "1619507415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 889",
            "city": "WASHINGTON",
            "state": "IA",
            "postal_code": "523530889",
            "telephone_number": "319-653-2047",
            "fax_number": "319-653-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 N 8TH AVE",
            "city": "WASHINGTON",
            "state": "IA",
            "postal_code": "523532618",
            "telephone_number": "319-653-2047",
            "fax_number": "319-653-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF WASHINGTON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WASHINGTON COUNTY AMBULANCE SERVICE",
        "enumeration_date": "2020-01-21",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A",
        "authorized_official_last_name": "PECK",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "ARTHUR",
        "authorized_official_title_or_position": "AMBULANCE DIRECTOR",
        "authorized_official_telephone_number": "319-653-2047",
        "authorized_official_credential": "PARAMEDIC"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Washington County Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Washington, IA

Sources for this page

Verify at the official NPI Registry.