County of Gem

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

7306 Issued in ID

Legal business name

COUNTY OF GEM

Practice address

330 E Main St
Emmett, ID 83617-3034

Phone

(208) 365-3684

Fax

(208) 365-3683

NPI assigned

Aug 3, 2006

Organization subpart

No

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

Authorized official

Name

Jeanie Edith M. Harris, NREMT-I

Title

Deputy Emt- Billing

Phone

(208) 365-3684

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• GEM COUNTY AMBULANCE Doing business as

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

• Walter Knox Memorial Hospital

  • Critical Access Hospital
  • Emmett, ID
  • NPI 1063419018

  Member Of

  NPD member
• Walter Knox Memorial Hospital

  • Rural Health Clinic/Center
  • Emmett, ID
  • NPI 1821091083

  Member Of

  NPD member

Locations

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Walter Knox Memorial Hospital

  • Critical Access Hospital
  • Emmett, ID
  • NPI 1063419018

  5% Or Greater Direct Ownership Interest

  CMS ownership
• Walter Knox Memorial Hospital

  • Specialist
  • Emmett, ID
  • NPI 1326206947

  5% Or Greater Direct Ownership Interest

  CMS ownership
• Walter Knox Memorial Hospital

  • Rural Health Clinic/Center
  • Emmett, ID
  • NPI 1821091083

  5% Or Greater Direct Ownership Interest

  CMS ownership
• Walter Knox Memorial Hospital

  • Family Medicine Physician
  • Emmett, ID
  • NPI 1861284721

  5% Or Greater Direct Ownership Interest

  CMS ownership

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195603200000",
    "number": "1912915448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 E MAIN ST",
            "address_2": "RM. 202",
            "city": "EMMETT",
            "state": "ID",
            "postal_code": "836173059",
            "telephone_number": "208-365-3684",
            "fax_number": "208-365-3683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 E MAIN ST",
            "city": "EMMETT",
            "state": "ID",
            "postal_code": "836173034",
            "telephone_number": "208-365-3684",
            "fax_number": "208-365-3683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF GEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-11-21",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "JEANIE",
        "authorized_official_middle_name": "EDITH M.",
        "authorized_official_title_or_position": "DEPUTY EMT- BILLING",
        "authorized_official_telephone_number": "208-365-3684",
        "authorized_official_credential": "NREMT-I"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "ID",
            "license": "7306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID - TYPE UNSPEC",
            "identifier": "1500010",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OMAP",
            "identifier": "275436",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010015165",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "E019-5",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GEM COUNTY AMBULANCE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cherry Gulch
• Clarity Counseling Connections
• Korin Collins, P.A.-C
• Kyle Spencer Conger, RN
• Darcy Renee Cook, N.P
• Crossroads Counseling
• Crossroads Counseling
• Maddie Crume
• D & a Wallace, Inc.
• Daniel M Pewe DC PC

• All providers in Emmett, ID
• Land Ambulance in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.