JICARILLA EMS (NPI# 1477684447) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477684447 |
| Entity Type | Organization |
| Organization Name | JICARILLA EMS |
| Practice Address |
2300 Narrow Gauge Rd Dulce NM 87528 |
| Mailing Address |
Pob 769 2300 Narrow Gauge Rd Dulce NM 87528 |
| Practice Telephone | 5757593778 |
| Practice Fax Number | 5757593841 |
| Mailing Telephone | 5757593778 |
| Mailing Fax Number | 5757593841 |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2013-02-21 |
| Authorized Official Name | MRS. DAWN BURNS (ACTING DIRECTOR) |
| Authorized Official Telephone | 5757593778 |
| Is Organization Subpart | Y |
| Parent Organization Name | JUCARILLA EMS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3416L0300X |
Ambulance Specialization: Land Transport |
47495 | NM | Transportation Services |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | BLUE CROSS BLUE SHIELD | R134 | 01 |
| NM | R2939 | 05 |
| Street Address |
2300 NARROW GAUGE RD |
| City | DULCE |
| State | NM |
| Zip Code | 87528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164917373 | Kelly Rae Pettigrew | Optometrist | 505 North Mundo, Dulce, NM 87528 | 2018-06-29 |
| 1780003442 | Jacob Alexander | Preventive Medicine | 500 N. Mundo, Dulce, NM 87528 | 2014-04-09 |
| 1881020089 | Jicarilla Apache Nation | Clinic/Center | 450 N Mundo Dr., Dulce, NM 87528 | 2013-09-19 |
| 1285971515 | Samuel Taylor Cropp | Pharmacist | 500 N Mundo Dr, Dulce, NM 87528 | 2013-01-07 |
| 1720331697 | Northwest Reional Education Coop #2 | Student in an Organized Health Care Education/Training Program | 91 Hawk Drive, Dulce, NM 87528 | 2012-10-17 |
| 1306116066 | Michael Shawn Kennedy | Psychologist | 113 Hawk Dr, Dulce, NM 87528 | 2012-01-11 |
| 1669762043 | Veronica A Medlin | Technician, Pathology | 1200 Stone Lake Rd, Dulce, NM 87528 | 2011-04-19 |
| 1891085262 | Stella Elizabeth Wilson | Spec/Tech, Pathology | 500 Stone Lake Road, Dulce, NM 87528 | 2011-04-19 |
| 1134419518 | Ray Morris Joe | Technician, Pathology | 500 North Mundo Road, Dulce, NM 87528 | 2011-04-19 |
| 1801186341 | Raquel Irene Cisneros | Family Medicine | 500 N. Mundo Dr., Dulce, NM 87528 | 2011-04-18 |
| Find all providers in zip 87528 | ||||
| Taxonomy Code | 3416L0300X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| Specialization | Land Transport |
| Definition to come... |
| Notes: [1/1/2005: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720568074 | County of Harding | Ambulance | 1361 Bravo Dome Hwy, Amistad, NM 88411 | 2018-08-16 |
| 1487188785 | Las Cruces Fire Department | Ambulance | 201 E Picacho Ave, Las Cruces, NM 88001-3456 | 2017-04-13 |
| 1891100137 | County of Union | Ambulance | 338 Dodge St, Folsom, NM 88419-0370 | 2014-06-25 |
| 1043641558 | Mescalero Apache Tribe | Ambulance | 25220 Highway 70, Mescalero, NM 88340 | 2013-12-09 |
| 1104267350 | Town of Elida | Ambulance | 405 Clark St, Elida, NM 88116 | 2013-07-16 |
| 1306284682 | City of Moriarty | Ambulance | 201 Broadway Se, Moriarty, NM 87035 | 2013-06-10 |
| 1457606147 | Western States C.c.t. Inc | Ambulance | 424 Harris Rd, Las Vegas, NM 87701-4840 | 2012-07-18 |
| 1508182007 | Village of Des Moines | Ambulance | 77 North Olive St, Des Moines, NM 88418 | 2010-04-09 |
| 1225265242 | Village of Floyd | Ambulance | 1572 New Mexico 267, Floyd, NM 88118-0069 | 2009-06-17 |
| 1679716419 | Pueblo of Acoma | Ambulance | 74 Indian Service, Route 32, Acoma, NM 87034-0000 | 2009-04-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.