Jerome Tyrrell Jerome IV, EMT

Primary specialty

Basic Emergency Medical TechnicianTaxonomy code 146N00000X

License

EMS.ES.70111053 Issued in WA

Practice address

913 Koala Dr
Omak, WA 98841-9576

Phone

(509) 663-4602

NPI assigned

Apr 30, 2026

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Emergency Medical Technician

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lifeline Ambulance, Inc.

  • Ambulance
  • E Wenatchee, WA
  • NPI 1881684132
  NPD (past)

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

{
    "created_epoch": "1777507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1649117474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12310 VILLAGE VIEW DR",
            "city": "LEAVENWORTH",
            "state": "WA",
            "postal_code": "988269169",
            "telephone_number": "509-881-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 KOALA DR",
            "city": "OMAK",
            "state": "WA",
            "postal_code": "988419576",
            "telephone_number": "509-663-4602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEROME",
        "first_name": "JEROME",
        "middle_name": "TYRRELL",
        "name_suffix": "IV",
        "credential": "EMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-04-30",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "WA",
            "license": "EMS.ES.70111053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Deane Jacobsen, LICENSED COUNSELOR
• Jaima Rose Jameson
• Brian Jamison
• Rekha Jayaprakash, DDS, MS
• Cynthia Jayne
• Jodie Field & Associates, LLC
• Robert Johansen, PA-C
• Jessica M Johnson, RN
• Terri L Johnson, ARNP
• Bryan Jones

• Basic Emergency Medical Technician in Omak, WA
• Providers in Omak, WA by specialty
• Basic Emergency Medical Technician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2026; 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.