NPIMap

Organization Active NPI

Lifepoint Ambulance LLC

Doing business as LifePoint Ambulance

  • Land Ambulance
  • Roberta, GA
National Provider Identifier
1053870451
Registry record updated Mar 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
LIFEPOINT AMBULANCE LLC
Doing business as
LifePoint Ambulance
Practice address
1011 Hwy 341 North
Suite 20 a
Roberta, GA 31078
Phone
(478) 714-3612
NPI assigned
Mar 15, 2019
Last updated
Mar 15, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2019

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

Authorized official

Name
Jacob Chance McCullough, AMBULANCE SERVICE
Title
Owner/Member
Phone
(478) 714-3612

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

1011 Hwy 341 North
Suite 20 a
Roberta, GA 31078

Mailing address

1011 Hwy 341 North
Suite 20 a
Roberta, GA 31078
Phone (478) 714-3612

Other names 1

  • LifePoint Ambulance Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1552608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552608000000",
    "number": "1053870451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 HWY 341 NORTH",
            "address_2": "SUITE 20 A",
            "city": "ROBERTA",
            "state": "GA",
            "postal_code": "31078",
            "telephone_number": "478-714-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 HWY 341 NORTH",
            "address_2": "SUITE 20 A",
            "city": "ROBERTA",
            "state": "GA",
            "postal_code": "31078",
            "telephone_number": "478-714-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEPOINT AMBULANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-15",
        "last_updated": "2019-03-15",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "CHANCE",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "478-714-3612",
        "authorized_official_credential": "AMBULANCE SERVICE"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifePoint Ambulance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roberta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.