Grace Care Ambulance Transport, LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

GRACE CARE AMBULANCE TRANSPORT, LLC

Practice address

2372 S Stone Mountain Rd.
Ste D
Lithonia, GA 30058

Phone

(404) 585-4857

Fax

(404) 521-4686

NPI assigned

Dec 5, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Carlton Theodore Anthony

Title

Owner

Phone

(404) 585-4857

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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": "1512432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748390400000",
    "number": "1003321662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2372 S STONE MOUNTAIN RD",
            "address_2": "SUITE D",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "30058",
            "telephone_number": "404-585-4857",
            "fax_number": "404-393-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2372 S STONE MOUNTAIN RD.",
            "address_2": "STE D",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "30058",
            "telephone_number": "404-585-4857",
            "fax_number": "404-521-4686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE CARE AMBULANCE TRANSPORT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-05",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-13",
        "status": "A",
        "authorized_official_last_name": "ANTHONY",
        "authorized_official_first_name": "CARLTON",
        "authorized_official_middle_name": "THEODORE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-585-4857",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; 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.