White Oak Medical Transport

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

WHITE OAK MEDICAL TRANSPORT

Practice address

446 White Oak Rd
Windsor, NC 27983-8006

Phone

(252) 794-4772

Fax

(252) 794-2089

NPI assigned

Feb 22, 2007

Organization subpart

No

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

Authorized official

Name

Pamela White Revels

Title

President Owner

Phone

(252) 794-4772

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689897600000",
    "number": "1114052149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 WHITE OAK RD",
            "city": "WINDSOR",
            "state": "NC",
            "postal_code": "279838006",
            "telephone_number": "252-794-4772",
            "fax_number": "252-794-2089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 WHITE OAK RD",
            "city": "WINDSOR",
            "state": "NC",
            "postal_code": "279838006",
            "telephone_number": "252-794-4772",
            "fax_number": "252-794-2089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE OAK MEDICAL TRANSPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A",
        "authorized_official_last_name": "REVELS",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "WHITE",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "252-794-4772"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NC",
            "license": "0081248",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3406794",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Windsor, NC
• Providers in Windsor, NC by specialty
• Land Ambulance in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; 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.