Organization Active NPI

Camden County Commissioner of

Doing business as Camden County Fire Rescue

  • Land Ambulance
  • Kingsland, GA
National Provider Identifier
1093782732
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
020-01 Issued in GA
Legal business name
CAMDEN COUNTY COMMISSIONER OF
Doing business as
Camden County Fire Rescue
Practice address
125 N Gross Rd
Kingsland, GA 31548-6237
Phone
(912) 729-1056
Fax
(912) 729-6527
NPI assigned
Mar 1, 2006
Last updated
Mar 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Authorized official

Name
Mr. Patrick Parson
Title
Director
Phone
(912) 729-1056

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 020-01 GA Primary

Addresses

Primary practice location

125 N Gross Rd
Kingsland, GA 31548-6237

Mailing address

PO Box 9150
Paducah, KY 42002-9150
Phone (270) 744-9600

Other identifiers 1

IdentifierTypeStateIssuer
000002791AMedicaidGA

Other names 1

  • CAMDEN COUNTY FIRE RESCUE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040917000627 GA Part B Supplier - Ambulance Service Supplier 2466420443 Practice locations: Woodbine, GA; Waverly, GA; Saint Marys, GA; Kingsland, GA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2203386Camden County Fire Rescue125 North Gross Road, Kingsland, GA 31548Certificate of waiverDec 2, 2026

National Provider Directory

National Provider Directory
Tax ID family
Camden County Fire Resc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

125 N Gross Rd
Kingsland, GA 31548
Phone (912) 729-1056

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1093782732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9150",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420029150",
            "telephone_number": "270-744-9600",
            "fax_number": "270-744-8642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 N GROSS RD",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486237",
            "telephone_number": "912-729-1056",
            "fax_number": "912-729-6527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMDEN COUNTY COMMISSIONER OF",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-01",
        "last_updated": "2024-03-27",
        "certification_date": "2023-07-25",
        "status": "A",
        "authorized_official_last_name": "PARSON",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "912-729-1056",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "GA",
            "license": "020-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000002791A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAMDEN COUNTY FIRE RESCUE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CAMDEN COUNTY FIRE RESCUE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kingsland, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.