County of Madison

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

7708 Issued in ID

Legal business name

COUNTY OF MADISON

Practice address

134 E Main St
Rexburg, ID 83440-1922

Phone

(208) 359-3010

Fax

(208) 359-3003

NPI assigned

Nov 2, 2006

Organization subpart

No

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

Authorized official

Name

Corey Child

Title

Fire Chief

Phone

(208) 359-3010

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MADISON COUNTY AMBULANCE Doing business as

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Siddoway, LCSW

  • Clinical Social Worker
  • Idaho Falls, ID
  • NPI 1235523457
  NPD

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461801600000",
    "number": "1740369784",
    "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": "800-585-5242",
            "fax_number": "360-394-7099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 E MAIN ST",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401922",
            "telephone_number": "208-359-3010",
            "fax_number": "208-359-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF MADISON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2016-04-28",
        "status": "A",
        "authorized_official_last_name": "CHILD",
        "authorized_official_first_name": "COREY",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "208-359-3010"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "ID",
            "license": "7708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002943800",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MADISON COUNTY AMBULANCE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cornerstone Caregiving West LLC
• Cornerstone Family Dental PLLC
• Couch-Burtenshaw Dental
• Counseling & Treatment Center of Idaho
• Counseling & Treatment Center of Idaho, LLC
• County of Madison School District 321
• Covey and Smith LLC
• Abigail Dawn Crandall
• Cress Creek Counseling PLLC
• Cress Creek Counseling PLLC

• Land Ambulance in Rexburg, ID
• Providers in Rexburg, ID by specialty
• Land Ambulance in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; 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.