NPIMap

Organization Active NPI

J K Ambulance

  • Ambulance
  • Kendrick, ID
National Provider Identifier
1972690451
Registry record updated Jun 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
7216 Issued in ID
Legal business name
J K AMBULANCE
Practice address
No Street Address N 6TH St
Kendrick, ID 83537
Phone
(208) 289-3381
Fax
(208) 289-5050
NPI assigned
Oct 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2012

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

Authorized official

Name
Mr. Perry Shove
Title
President
Phone
(208) 276-3789

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 7216 ID Primary

Addresses

Primary practice location

No Street Address N 6TH St
Kendrick, ID 83537

Mailing address

PO Box 182
Kendrick, ID 83537-0182
Phone (208) 289-3381

Other identifiers 1

IdentifierTypeStateIssuer
002514200MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080411000603 ID Part B Supplier - Ambulance Service Supplier 4880771054 Practice locations: Kendrick, ID

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340841600000",
    "number": "1972690451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 182",
            "city": "KENDRICK",
            "state": "ID",
            "postal_code": "835370182",
            "telephone_number": "208-289-3381",
            "fax_number": "208-289-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NO STREET ADDRESS N 6TH ST",
            "city": "KENDRICK",
            "state": "ID",
            "postal_code": "83537",
            "telephone_number": "208-289-3381",
            "fax_number": "208-289-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J K AMBULANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2012-06-28",
        "status": "A",
        "authorized_official_last_name": "SHOVE",
        "authorized_official_first_name": "PERRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-276-3789",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "ID",
            "license": "7216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002514200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kendrick, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2012; 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.