Individual provider Active NPI

Lynnell Maurice Bushrod

  • Land Ambulance
  • Atlanta, GA
National Provider Identifier
1063285047
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Practice address
8735 Dunwoody PL Ste 4306
Atlanta, GA 30350-2995
Phone
(678) 973-8379
NPI assigned
Nov 1, 2023
Last updated
Nov 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

8735 Dunwoody PL Ste 4306
Atlanta, GA 30350-2995

Mailing address

8735 Dunwoody PL Ste 4306
Atlanta, GA 30350-2995
Phone (678) 973-8379

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1698796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1063285047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8735 DUNWOODY PL STE 4306",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303502995",
            "telephone_number": "678-973-8379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8735 DUNWOODY PL STE 4306",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303502995",
            "telephone_number": "678-973-8379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSHROD",
        "first_name": "LYNNELL",
        "middle_name": "MAURICE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-01",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2023; 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.