Lifeguard Ambulance Service LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

LIFEGUARD AMBULANCE SERVICE LLC

Practice address

411 W Main St
Waverly, TN 37185-1107

Phone

(931) 296-2355

NPI assigned

May 11, 2017

Last updated

Feb 10, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

LIFEGUARD AMBULANCE SERVICE LLCAs reported in NPPES

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

Authorized official

Name

Eric Thomas

Title

SVP of Revenue Management

Phone

(833) 703-2294

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Lifeguard Ambulance Service LLC

  • Land Ambulance
  • Knoxville, TN
  • NPI 1407274947

  O20140729000427

  Same enrollment

Part of

Lifeguard Ambulance Servi

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1043746902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198408",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848408",
            "telephone_number": "800-913-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W MAIN ST",
            "city": "WAVERLY",
            "state": "TN",
            "postal_code": "371851107",
            "telephone_number": "931-296-2355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEGUARD AMBULANCE SERVICE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFEGUARD AMBULANCE SERVICE LLC",
        "enumeration_date": "2017-05-11",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "SVP OF REVENUE MANAGEMENT",
        "authorized_official_telephone_number": "833-703-2294"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James H King, O.D.
• Ernest Bobby Kleier Jr., MD
• Lawrence Richard Jackson Jr. MD
• Linda Cleo Leonard, RPH
• Carolyn D Lewallen
• Rebecca Loatwall, FNP-C
• Magnolia Meadows LLC
• Yolanda Kay Maness
• Robert Wayne Martin Sr., DDS
• Kimberly Lynn Masengill, FNP-BC, CNM

• Land Ambulance in Waverly, TN
• Providers in Waverly, TN by specialty
• Land Ambulance in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.

Verify at the official NPI Registry.