Active NPI
Lakeport County Fire Protection District
- Land Ambulance
- Lakeport, CA
National Provider Identifier
1922008408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- Legal business name
- LAKEPORT COUNTY FIRE PROTECTION DISTRICT
- Practice address
- 445 N Main St
Lakeport, CA 95453-4809 - Phone
- (707) 263-4396
- Fax
- (707) 262-1283
- NPI assigned
- Jul 27, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Douglas P Hutchison
- Title
- Fire Chief
- Phone
- (707) 263-4396
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | Primary |
Addresses
Primary practice location
445 N Main St
Lakeport, CA 95453-4809
Mailing address
PO Box 2930
Santa Rosa, CA 95405-0930
Phone (707) 571-2323
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 590014384 | Other | RRB | |
| MTE00688F | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080204000691 | CA | Part B Supplier - Ambulance Service Supplier | 5496837023 | Practice locations: Lakeport, CA |
National Provider Directory
National Provider DirectoryLocations
445 N Main St
Lakeport, CA 95453
Phone (707) 263-4396
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122422400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1405900800000",
"number": "1922008408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2930",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954050930",
"telephone_number": "707-571-2323",
"fax_number": "707-571-2362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "445 N MAIN ST",
"city": "LAKEPORT",
"state": "CA",
"postal_code": "954534809",
"telephone_number": "707-263-4396",
"fax_number": "707-262-1283"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LAKEPORT COUNTY FIRE PROTECTION DISTRICT",
"organizational_subpart": "NO",
"enumeration_date": "2005-07-27",
"last_updated": "2014-07-21",
"status": "A",
"authorized_official_last_name": "HUTCHISON",
"authorized_official_first_name": "DOUGLAS",
"authorized_official_middle_name": "P",
"authorized_official_title_or_position": "FIRE CHIEF",
"authorized_official_telephone_number": "707-263-4396"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RRB",
"identifier": "590014384",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MTE00688F",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lakeport, CA
- Lake County Tribal Health Consortium Inc.
- Lake County Tribal Health Consortium, Inc. (Tribal Health Pediatrics)
- Lake County Tribal Health Consortium, Inc. (Lake County Tribal Health Pharmacy)
- Lake Dermatology Medical Assoc Inc
- Lake Family Resource Center
- Lakeport Emergency Medical Corporation
- Lakeport Medical Group
- Lakeport Neurology Inc
- Lakeport Physical Therapy, Inc.
- Lakeport Post Acute, LLC (Lakeport Post Acute)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2014; 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.