Cocke County Ambulance Service Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

EMS0000010024 Issued in TN

Legal business name

COCKE COUNTY AMBULANCE SERVICE INC

Practice address

245 Bybee Rd
Newport, TN 37821-4603

Phone

(423) 608-3109

Fax

(623) 625-4043

NPI assigned

Mar 29, 2006

Last updated

Aug 22, 2020By 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

Jerry A Holt, PARAMEDIC

Title

Owner

Phone

(423) 608-3109

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871554824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 BYBEE RD",
            "city": "NEWPORT",
            "state": "TN",
            "postal_code": "378214603",
            "telephone_number": "423-608-3109",
            "fax_number": "623-625-4043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 BYBEE RD",
            "city": "NEWPORT",
            "state": "TN",
            "postal_code": "378214603",
            "telephone_number": "423-608-3109",
            "fax_number": "623-625-4043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COCKE COUNTY AMBULANCE SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLT",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-608-3109",
        "authorized_official_credential": "PARAMEDIC"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "TN",
            "license": "EMS0000010024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3574698",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "4096970",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Center for Industrial Health
• Cherokee Health Systems (River Valley Health)
• Cherokee Health Systems
• Class 'a' Clinic LLC
• Beverly Joanne Clontz, PSYD
• Cocke County Hma LLC
• Cocke County Hma LLC
• Cocke County Hma LLC (Tennova Newport-4th Street)
• Cocke County Hma LLC (Tennova Newport Convalescent Center)
• Cocke County Hma, LLC (Tennova Healthcare-Newport Medical Center)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.