South Lincoln Ambulance Inc.

Primary specialty

ParamedicTaxonomy code 146L00000X

License

2112-06 Issued in OR

Legal business name

SOUTH LINCOLN AMBULANCE INC.

Practice address

215 W 2ND St
Yachats, OR 97498

Phone

(541) 547-3266

Fax

(541) 547-4257

NPI assigned

Aug 12, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Frances M Petrick

Title

Ambulance Chief

Phone

(541) 547-3266

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• South Lincoln Ambulance Association Other name

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356566400000",
    "number": "1811999535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31",
            "city": "YACHATS",
            "state": "OR",
            "postal_code": "974980031",
            "telephone_number": "541-547-3766",
            "fax_number": "541-547-4257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 W 2ND ST",
            "city": "YACHATS",
            "state": "OR",
            "postal_code": "97498",
            "telephone_number": "541-547-3266",
            "fax_number": "541-547-4257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH LINCOLN AMBULANCE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-12",
        "last_updated": "2012-12-27",
        "status": "A",
        "authorized_official_last_name": "PETRICK",
        "authorized_official_first_name": "FRANCES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "AMBULANCE CHIEF",
        "authorized_official_telephone_number": "541-547-3266",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "146L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medical Technician, Paramedic",
            "state": "OR",
            "license": "2112-06",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "006352000",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "189407",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Lincoln Ambulance Association",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Norma Houchin Elliott, CCC-SLP
• Bruce Prentiss Ladd, LAC
• Pierre Morin, PH.D.
• Regina Marie Nowatzke, LCSW
• Zeora Sage, LMT
• Yachats Community Health Clinic
• Yachats Rural Fire Protection District

• Paramedic in Yachats, OR
• Providers in Yachats, OR by specialty
• Paramedic in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.