North Lake County Emergency Medical Service, Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

NORTH LAKE COUNTY EMERGENCY MEDICAL SERVICE, INC.

Practice address

87391 Holly Lane
Christmas Valley, OR 97641-0423

Phone

(541) 576-2759

NPI assigned

Mar 7, 2007

Organization subpart

No

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

Authorized official

Name

Patty Effingham

Title

Treasurer

Phone

(541) 576-2640

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357257600000",
    "number": "1780714824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 423",
            "city": "CHRISTMAS VALLEY",
            "state": "OR",
            "postal_code": "976410423",
            "telephone_number": "541-576-2759",
            "fax_number": "541-576-3554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87391 HOLLY LANE",
            "city": "CHRISTMAS VALLEY",
            "state": "OR",
            "postal_code": "976410423",
            "telephone_number": "541-576-2759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH LAKE COUNTY EMERGENCY MEDICAL SERVICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2013-01-04",
        "status": "A",
        "authorized_official_last_name": "EFFINGHAM",
        "authorized_official_first_name": "PATTY",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "541-576-2640"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn Kimberly Lavallee
• Emily Louise Merwin
• Kendra Murphy
• North Lake Clinic LLC (North Lake Clinic)
• North Lake Clinic, LLC
• Pat Widenoja FNP (North Lake Clinic)
• Holly Vore, QMHP1

• Land Ambulance in Christmas Valley, OR
• Providers in Christmas Valley, OR by specialty
• Land Ambulance in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; 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.