Jjdac, LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

JJDAC, LLC

Practice address

208 W Maloney Ave
Gallup, NM 87301-5214

Phone

(505) 722-5295

Fax

(575) 523-0459

NPI assigned

Dec 18, 2017

Organization subpart

Yes

Parent organization

JJDAC, LLCAs reported in NPPES

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

Authorized official

Name

Brian Scott Tierney

Title

Evp, Chief Financial Officer

Phone

(833) 703-2294

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Med Star Ambulance Other name

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Jjdac LLC

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• American Medical Response Ambulance Service Inc

  • Ambulance
  • Riverside, CA
  • NPI 1578597886

  Member Of

  NPD member

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Jjdac Inc.

  • Ambulance
  • Gallup, NM
  • NPI 1093883787
  NPPES parent name

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

{
    "created_epoch": "1513555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774396800000",
    "number": "1922514686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 56141",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900746141",
            "telephone_number": "800-913-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 W MALONEY AVE",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015214",
            "telephone_number": "505-722-5295",
            "fax_number": "575-523-0459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JJDAC, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JJDAC, LLC",
        "enumeration_date": "2017-12-18",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A",
        "authorized_official_last_name": "TIERNEY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "EVP, CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "833-703-2294"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15677567",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Med Star Ambulance",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Med Star Ambulance",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Debra Jenkins, RN
• Jacob Jennings, DDS
• Leroy Jim, LPCC, CRC
• Debora Jimenez, RN
• Jjdac Inc.
• Kasha K John
• Michelle John
• Vera D John, LPCC
• Eugenia M Johns, RN
• Alexis Johnson, TAXONOMY CODE

• Land Ambulance in Gallup, NM
• Providers in Gallup, NM by specialty
• Land Ambulance in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.