Crooked River Ranch Fire Protection District VI-503

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1613-06 Issued in OR

Legal business name

CROOKED RIVER RANCH FIRE PROTECTION DISTRICT VI-503

Doing business as

Crooked River Ranch RFPD

Practice address

6971 SW Shad Rd
Terrebonne, OR 97760-7792

Phone

(541) 923-6776

Fax

(541) 923-5247

NPI assigned

Oct 4, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Mark W Wilson

Title

Fire Chief

Phone

(541) 923-6776

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Crooked River Ranch RFPD Doing business as

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

Locations

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396310400000",
    "number": "1861587578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6971 SW SHAD RD",
            "city": "TERREBONNE",
            "state": "OR",
            "postal_code": "977607792",
            "telephone_number": "541-923-6776",
            "fax_number": "541-923-5247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6971 SW SHAD RD",
            "city": "TERREBONNE",
            "state": "OR",
            "postal_code": "977607792",
            "telephone_number": "541-923-6776",
            "fax_number": "541-923-5247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROOKED RIVER RANCH FIRE PROTECTION DISTRICT VI-503",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2014-04-01",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "541-923-6776",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OR",
            "license": "1613-06",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "59008157",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177220",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "081971000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crooked River Ranch RFPD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Land Ambulance in Terrebonne, OR
• Providers in Terrebonne, OR by specialty
• Land Ambulance in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2014; 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.