Fentress County

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

EMS0000002501 Issued in TN

Legal business name

FENTRESS COUNTY

Doing business as

Fentress County Ambulance Service

Practice address

310 S Main St
Jamestown, TN 38556-3845

Phone

(931) 879-3319

Fax

(931) 879-2943

NPI assigned

Jun 17, 2006

Last updated

Mar 21, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Micah Dunford

Title

Director

Phone

(931) 879-3319

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Fentress County Ambulance Service Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

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": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553126400000",
    "number": "1871538728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 S MAIN ST",
            "address_2": "P.O. BOX 905",
            "city": "JAMESTOWN",
            "state": "TN",
            "postal_code": "385563845",
            "telephone_number": "931-879-3319",
            "fax_number": "931-879-2943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 S MAIN ST",
            "city": "JAMESTOWN",
            "state": "TN",
            "postal_code": "385563845",
            "telephone_number": "931-879-3319",
            "fax_number": "931-879-2943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FENTRESS COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2019-03-21",
        "status": "A",
        "authorized_official_last_name": "DUNFORD",
        "authorized_official_first_name": "MICAH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "931-879-3319"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "TN",
            "license": "EMS0000002501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3524189",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fentress County Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fentress County Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alesa Fisher Esh, R.D,, L.D.N.
• Essential 3 Home Care LLC
• Eye Centers of Tennessee, LLC
• Fast Pace Medical Clinic PLLC
• Fast Pace Medical Clinic PLLC
• Fentress County Board of Education
• Fentress Family Care LLC (Jamestown Family Care Clinic)
• Fentress Family Practice PLLC (Fentress Family Practice)
• Fentress Health Systems, LLC
• Katy Lynn Flowers, F.N.P.

• Land Ambulance in Jamestown, TN
• Providers in Jamestown, TN by specialty
• Land Ambulance in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2019; 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.