Active NPI
Brantley County EMS
- Land Ambulance
- Nahunta, GA
National Provider Identifier
1013041615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 01301
- Legal business name
- BRANTLEY COUNTY EMS
- Practice address
- 1366 Broome Street
Nahunta, GA 31553 - Phone
- (912) 462-5380
- Fax
- (912) 462-5309
- NPI assigned
- Mar 15, 2007
- Last updated
- Aug 25, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Gary W Riggan
- Title
- Director
- Phone
- (912) 462-5380
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 01301 | GA | Primary |
Addresses
Primary practice location
1366 Broome Street
Nahunta, GA 31553
Mailing address
PO Box 798
Nahunta, GA 31553-0798
Phone (912) 462-5380
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00180342A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041102000891 | GA | Part B Supplier - Ambulance Service Supplier | 5092777953 | Practice locations: Nahunta, GA |
National Provider Directory
National Provider DirectoryLocations
1366 Broome St
Nahunta, GA 31553
Phone (912) 462-5318
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1661385600000",
"number": "1013041615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 798",
"city": "NAHUNTA",
"state": "GA",
"postal_code": "315530798",
"telephone_number": "912-462-5380",
"fax_number": "912-462-5309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1366 BROOME STREET",
"city": "NAHUNTA",
"state": "GA",
"postal_code": "31553",
"telephone_number": "912-462-5380",
"fax_number": "912-462-5309"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BRANTLEY COUNTY EMS",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-15",
"last_updated": "2022-08-25",
"certification_date": "2022-08-25",
"status": "A",
"authorized_official_last_name": "RIGGAN",
"authorized_official_first_name": "GARY",
"authorized_official_middle_name": "W",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "912-462-5380"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "GA",
"license": "01301",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00180342A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nahunta, GA
- Bennett's Hometown Pharmacy, LLC
- Blackshear Family Practice
- Kristen Lee Bowers
- Brantley County Board of Education
- Brantley County Board of Health
- Brantley Drug Company, LLC (Mark's Discount Drugs)
- Thomas Lee Brooks Jr., DMD
- Amber Marie Cason, PHARM.D.
- Kristy Chesser, FNP
- Coastal Community Health Services, Inc. (Heron Health Center- School Based Clinic)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; 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.