Active NPI
Gary Mark Carriere, EMT-B
- Basic Emergency Medical Technician
- Nespelem, WA
National Provider Identifier
1902013295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Basic Emergency Medical Technician
- License
- 131237
- Practice address
- 1 Colville Street
Nespelem, WA 99155 - Phone
- (509) 634-2727
- Fax
- (509) 634-2781
- NPI assigned
- May 17, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Basic Emergency Medical Technician | 146N00000X | 131237 | WA | Primary |
Addresses
Primary practice location
1 Colville Street
Nespelem, WA 99155
Mailing address
1 Colville Street
Nespelem, WA 99155
Phone (509) 634-2727
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9545807 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 131237 | WA | MD | Basic Emergency Medical Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1902013295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 COLVILLE STREET",
"city": "NESPELEM",
"state": "WA",
"postal_code": "99155",
"telephone_number": "509-634-2727",
"fax_number": "509-634-2781"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 COLVILLE STREET",
"city": "NESPELEM",
"state": "WA",
"postal_code": "99155",
"telephone_number": "509-634-2727",
"fax_number": "509-634-2781"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRIERE",
"first_name": "GARY",
"middle_name": "MARK",
"credential": "EMT-B",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-17",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "146N00000X",
"taxonomy_group": "",
"desc": "Emergency Medical Technician, Basic",
"state": "WA",
"license": "131237",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9545807",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nespelem, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.