NPIMap

Organization Active NPI

Heartland EMS Inc

Doing business as Heartland EMS - Waycross

  • Land Ambulance
  • Waycross, GA
National Provider Identifier
1164732285
Registry record updated Feb 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
012-04 Issued in GA
Legal business name
HEARTLAND EMS INC
Doing business as
Heartland EMS - Waycross
Practice address
800 Memorial Dr Ste B
Waycross, GA 31501-2904
Phone
(478) 934-1133
Fax
(478) 934-0730
NPI assigned
Oct 8, 2010
Last updated
Feb 23, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2018

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

Authorized official

Name
Mr. W. J. Cheek
Title
President
Phone
(478) 934-1133

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 012-04 GA Primary

Addresses

Primary practice location

800 Memorial Dr Ste B
Waycross, GA 31501-2904

Mailing address

PO Box 636
Cochran, GA 31014-0636
Phone (478) 934-1133

Other names 1

  • Heartland EMS - Waycross Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041018000900 GA Part B Supplier - Ambulance Service Supplier 0547220121 10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cochran, GA; Dublin, GA; Hawkinsville, GA

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

800 Memorial Dr
Ste B
Waycross, GA 31501

NPI Registry JSON

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

{
    "created_epoch": "1286496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519344000000",
    "number": "1164732285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636",
            "city": "COCHRAN",
            "state": "GA",
            "postal_code": "310140636",
            "telephone_number": "478-934-1133",
            "fax_number": "478-934-0730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MEMORIAL DR STE B",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315012904",
            "telephone_number": "478-934-1133",
            "fax_number": "478-934-0730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND EMS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-08",
        "last_updated": "2018-02-23",
        "status": "A",
        "authorized_official_last_name": "CHEEK",
        "authorized_official_first_name": "W.",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "478-934-1133",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "GA",
            "license": "012-04",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heartland EMS - Waycross",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waycross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2018; 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.