Organization Active NPI

Acute Rescue and Transport, Inc

  • Ambulance
  • Boise, ID
National Provider Identifier
1790064517
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
6800 Issued in ID
Legal business name
ACUTE RESCUE AND TRANSPORT, INC
Practice address
6055 W Corporal LN
Boise, ID 83704-9315
Phone
(208) 965-8072
Fax
(208) 965-8074
NPI assigned
Aug 10, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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

Authorized official

Name
Mr. Wesley Dean Anderson
Title
President
Phone
(208) 965-8072

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 6800 ID Primary

Addresses

Primary practice location

6055 W Corporal LN
Boise, ID 83704-9315

Mailing address

6055 W Corporal LN
Boise, ID 83704-9315
Phone (208) 965-8072

Other identifiers 1

IdentifierTypeStateIssuer
A0000846MedicaidID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111013000322 ID Part B Supplier - Ambulance Service Supplier 6204008345 Practice locations: Boise, ID; Pocatello, ID

National Provider Directory

National Provider Directory

Locations

6055 W Corporal Ln
Boise, ID 83704
Phone (208) 965-8072

6057 W Corporal Ln
Boise, ID 83704
Phone (208) 965-8072

525 E Clark St
Pocatello, ID 83201
Phone (208) 965-8072

NPI Registry JSON

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

{
    "created_epoch": "1312934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644278400000",
    "number": "1790064517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6055 W CORPORAL LN",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049315",
            "telephone_number": "208-965-8072",
            "fax_number": "208-965-8074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6055 W CORPORAL LN",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049315",
            "telephone_number": "208-965-8072",
            "fax_number": "208-965-8074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACUTE RESCUE AND TRANSPORT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-10",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-965-8072",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "ID",
            "license": "6800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A0000846",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; 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.