PHYLLIS MARIE GROSS (NPI# 1417165812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417165812 |
| Entity Type | Individual |
| Full Name | PHYLLIS MARIE GROSS |
| Credential | EMT-B |
| Practice Address |
1 Colville Street Nespelem WA 99155 |
| Practice Telephone | 5096342727 |
| Practice Fax Number | 5096342781 |
| Mailing Telephone | 5096342727 |
| Mailing Fax Number | 5096342781 |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 146N00000X | Emergency Medical Technician, Basic | 1170876 | WA | Emergency Medical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 9545807 | 05 |
| Street Address |
1 COLVILLE STREET |
| City | NESPELEM |
| State | WA |
| Zip Code | 99155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174625446 | Colville Confederated Tribes | Clinic/Center | 1 Colville Street, Nespelem, WA 99155-0150 | 2006-09-05 |
| 1922328533 | Ofa Meliame Redding | Counselor | 1 Colville Street, Nespelem, WA 99155 | 2010-06-04 |
| 1457677965 | Clinton John Nicholson | Counselor | 1 Colville Street, Nespelem, WA 99155 | 2010-04-09 |
| 1396975934 | Linda Lorraine Dick | Counselor | 1 Colville Street, Nespelem, WA 99155-0150 | 2009-07-16 |
| 1023248663 | Margaret Noreen Burchard | Counselor | 1 Colville Street, Nespelem, WA 99155-0150 | 2009-07-16 |
| 1891997508 | Brenda Karlene Jamison | Emergency Medical Technician, Basic | 1 Colville Street, Nespelem, WA 99155 | 2007-06-04 |
| 1588872972 | James Allen Tharpe | Emergency Medical Technician, Basic | 1 Colville Street, Nespelem, WA 99155 | 2007-05-18 |
| 1134337546 | John R Gross | Emergency Medical Technician, Intermediate | 1 Colville Street, Nespelem, WA 99155 | 2007-05-18 |
| 1568670966 | Richard Lavern Gorr | Emergency Medical Technician, Basic | 1 Colville Street, Nespelem, WA 99155 | 2007-05-18 |
| 1932317344 | Christopher Patrick Mccuen | Emergency Medical Technician, Basic | 1 Colville Street, Nespelem, WA 99155 | 2007-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841655727 | Brittany Carden | Counselor | 21 Colville St, Nespelem, WA 99155 | 2015-12-21 |
| 1265855704 | Linda Charlene Bart | Counselor | 19 Sanpoil St, Nespelem, WA 99155 | 2014-02-03 |
| 1811104334 | Lee Vernon Elton | Emergency Medical Technician, Intermediate | 1 Colville Streets, Nespelem, WA 99155 | 2007-05-16 |
| 1063542645 | Colville Indian Health Center Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Agency Campus Hwy 155, Nespelem, WA 99155 | 2007-03-06 |
| 1306993662 | Gloria H Angelo | Pharmacist | 29 Nespelem-sanpoil, Agency Campus, Nespelem, WA 99155 | 2007-01-05 |
| 1174607931 | Sandra Lee Nomee | Spec/Tech, Pathology | 29 9th Sanpoil Street, Colville Confederated Tribes Indian Health Services, Nespelem, WA 99155 | 2006-10-25 |
| 1265529598 | Confederated Tribes of The Colville Reservation | Ambulance | 405 10th St, Nespelem, WA 99155 | 2006-10-06 |
| 1316954118 | Jose Javier Gomez | Psychologist | 1 Colville St, Nespelem, WA 99155 | 2006-08-02 |
| 1922038884 | Donald L Sanford | Optometrist | 29 Nespelem/san Poil St, Nespelem, WA 99155 | 2006-07-04 |
| 1639131386 | Larry D Smith | Emergency Medicine | 19 Lakes Street, Nespelem, WA 99155 | 2006-04-06 |
| Find all providers in zip 99155 | ||||
| Taxonomy Code | 146N00000X |
| Grouping | Emergency Medical Service Providers |
| Classification | Emergency Medical Technician, Basic |
| A Basic EMT is an individual trained and certified to perform basic life support treatment in medical emergencies based on individual state boards. |
| Notes: Sources: Tabers Medical Dictionary and Florida EMS Clearing House. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891997508 | Brenda Karlene Jamison | Emergency Medical Technician, Basic | 1 Colville Street, Nespelem, WA 99155 | 2007-06-04 |
| 1588872972 | James Allen Tharpe | Emergency Medical Technician, Basic | 1 Colville Street, Nespelem, WA 99155 | 2007-05-18 |
| 1568670966 | Richard Lavern Gorr | Emergency Medical Technician, Basic | 1 Colville Street, Nespelem, WA 99155 | 2007-05-18 |
| 1932317344 | Christopher Patrick Mccuen | Emergency Medical Technician, Basic | 1 Colville Street, Nespelem, WA 99155 | 2007-05-18 |
| 1265649552 | Ronald Lawrence Shaffer | Emergency Medical Technician, Basic | 1 Colville Street, Nespelem, WA 99155 | 2007-05-17 |
| 1750598041 | Serenna Kathleen Taylor | Emergency Medical Technician, Basic | 1 Colville Street, Nespelem, WA 99155 | 2007-05-17 |
| 1063629350 | Lorinda Ann Goodman | Emergency Medical Technician, Basic | 1 Colville Street, Nespelem, WA 99155 | 2007-05-17 |
| 1851508147 | Donita A Swan | Emergency Medical Technician, Basic | 1 Colville Street, Nespelem, WA 99155 | 2007-05-17 |
| 1003023300 | Joleen Anne Mollenberg | Emergency Medical Technician, Basic | 1 Colville Street, Nespelem, WA 99155 | 2007-05-17 |
| 1558578864 | Rayna J Edwards | Emergency Medical Technician, Basic | 1 Colville Street, Nespelem, WA 99155 | 2007-05-17 |
| Find all providers in NESPELEM | ||||
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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.