Bannock County Ambulance District

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

8611 Issued in ID

Legal business name

BANNOCK COUNTY AMBULANCE DISTRICT

Practice address

408 E Whitman St
Pocatello, ID 83201-6450

Phone

(208) 234-6200

Fax

(208) 233-4043

NPI assigned

Nov 23, 2005

Last updated

Aug 22, 2020By 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

Mrs. Tami Wilson

Title

Administrative Assistant

Phone

(208) 234-6200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Locations

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962485946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 E WHITMAN ST",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832016450",
            "telephone_number": "208-234-6200",
            "fax_number": "208-233-4043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 E WHITMAN ST",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832016450",
            "telephone_number": "208-234-6200",
            "fax_number": "208-233-4043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNOCK COUNTY AMBULANCE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "TAMI",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "208-234-6200",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "ID",
            "license": "8611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Eileen Baird, DNP, FNP-C
• Andrew Baker, DO
• Mark Ensio Baker, D.D.S.
• Jenny May Ball, FNP
• Joette Ballard, PHARM D
• Bannock County Family Treatment Center
• Bannock County Juvenile Justice
• Bannock Inpatient Services PLLC
• Bannock Youth Foundation (M.K. Place)
• Sarah Nicolle Baquet, LPC

• Land Ambulance in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Land Ambulance in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.