Keithmedtransportationllc

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

KEITHMEDTRANSPORTATIONLLC

Practice address

522 Ponderosa Dr
Ponchatoula, LA 70454-9428

Phone

(504) 339-1372

Fax

(985) 370-2056

NPI assigned

Jan 19, 2020

Last updated

Jan 19, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Keith Jhon Gaines Sr.

Title

Transportation Provider

Phone

(504) 339-1372

Specialties & licenses 1

Addresses

Other names 1

• keithmedtransportationllc Former legal business name

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

{
    "created_epoch": "1579392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579392000000",
    "number": "1093345084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 PONDEROSA DR",
            "city": "PONCHATOULA",
            "state": "LA",
            "postal_code": "704549428",
            "telephone_number": "504-339-1372",
            "fax_number": "985-370-2056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 PONDEROSA DR",
            "city": "PONCHATOULA",
            "state": "LA",
            "postal_code": "704549428",
            "telephone_number": "504-339-1372",
            "fax_number": "985-370-2056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITHMEDTRANSPORTATIONLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-19",
        "last_updated": "2020-01-19",
        "certification_date": "2020-01-19",
        "status": "A",
        "authorized_official_last_name": "GAINES",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "JHON",
        "authorized_official_title_or_position": "TRANSPORTATION PROVIDER",
        "authorized_official_telephone_number": "504-339-1372",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "keithmedtransportationllc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Non-emergency Medical Transport (VAN) in Ponchatoula, LA
• Providers in Ponchatoula, LA by specialty
• Non-emergency Medical Transport (VAN) in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2020; 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.