Pend Oreille Paramedics

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

604090652 Issued in WA

Legal business name

PEND OREILLE PARAMEDICS

Practice address

137 S Newport Ave
Newport, WA 99156-1942

Phone

(509) 447-1200

Fax

(509) 447-1201

NPI assigned

Apr 7, 2017

Organization subpart

No

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

Authorized official

Name

John JacksonNPI 1184164493

Title

President

Phone

(509) 671-6699

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Jackson

  • Paramedic
  • Newport, WA
  • NPI 1184164493
  NPD (past) Authorized official

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

{
    "created_epoch": "1491523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517788800000",
    "number": "1902339849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1942",
            "address_2": "137 S NEWPORT AVE",
            "city": "NEWPORT",
            "state": "WA",
            "postal_code": "991561942",
            "telephone_number": "509-447-1202",
            "fax_number": "509-447-1201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 S NEWPORT AVE",
            "city": "NEWPORT",
            "state": "WA",
            "postal_code": "991561942",
            "telephone_number": "509-447-1200",
            "fax_number": "509-447-1201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEND OREILLE PARAMEDICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-07",
        "last_updated": "2018-02-05",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-671-6699"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WA",
            "license": "604090652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2089321",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pend Oreille County Public Hospital District No 1
• Pend Oreille County Public Hospital District No 1
• Pend Oreille County Public Hospital District No. 1
• Pend Oreille County Public Hospital District No. 1
• Pend Oreille Fire 3
• Pend Oreille River Emergency Physicians PLLC
• Elizabeth Peters
• Aaron Petersen, MD
• Lynn A Peterson, MSN, CRNA
• Molly O Phillips, LICMSW

• Land Ambulance in Newport, WA
• Providers in Newport, WA by specialty
• Land Ambulance in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.