Active NPI
Acute Rescue and Transport, Inc
- Ambulance
- Boise, ID
National Provider Identifier
1790064517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulance
- License
- 6800
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A0000846 | Medicaid | ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111013000322 | ID | Part B Supplier - Ambulance Service Supplier | 6204008345 | Practice locations: Boise, ID; Pocatello, ID |
National Provider Directory
National Provider DirectoryLocations
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.