Jordan Valley Ambulance Service

Primary specialty

AmbulanceTaxonomy code 341600000X

License

2301-06 Issued in OR

Legal business name

JORDAN VALLEY AMBULANCE SERVICE

Practice address

306 Blackaby St
Jordan Valley, OR 97910

Phone

(541) 586-2449

Fax

(541) 586-2449

NPI assigned

Aug 28, 2007

Last updated

Dec 3, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marie Clayton

Title

Billing Dept

Phone

(541) 586-2799

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196640000000",
    "number": "1952595522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 345",
            "city": "JORDAN VALLEY",
            "state": "OR",
            "postal_code": "979100345",
            "telephone_number": "541-586-2449",
            "fax_number": "541-586-2449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 BLACKABY ST",
            "city": "JORDAN VALLEY",
            "state": "OR",
            "postal_code": "97910",
            "telephone_number": "541-586-2449",
            "fax_number": "541-586-2449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JORDAN VALLEY AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-28",
        "last_updated": "2007-12-03",
        "status": "A",
        "authorized_official_last_name": "CLAYTON",
        "authorized_official_first_name": "MARIE",
        "authorized_official_title_or_position": "BILLING DEPT",
        "authorized_official_telephone_number": "541-586-2799"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "OR",
            "license": "2301-06",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Marie Donley Burge, CADC I
• Jordan Valley Health Clinic, Inc.
• Jordan Valley School District #3

• Ambulance in Jordan Valley, OR
• Providers in Jordan Valley, OR by specialty
• Ambulance in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; 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.