Essential Medical Response, LLC

Primary specialty

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

Legal business name

ESSENTIAL MEDICAL RESPONSE, LLC

Practice address

1005 Midway Rd SE
Bolivia, NC 28422-7541

Phone

(404) 200-4244

NPI assigned

Sep 15, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Samuel Goodman

Title

Ceo

Phone

(404) 200-4244

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663200000000",
    "number": "1174245161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 MIDWAY RD SE",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284227541",
            "telephone_number": "404-200-4244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 MIDWAY RD SE",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284227541",
            "telephone_number": "404-200-4244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSENTIAL MEDICAL RESPONSE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-15",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-200-4244",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• East Carolina University
• Selena Anne Ehlert, OTR/L
• Lani Ellis, P.A.-C
• Patricia Ellis, RD
• Patrick Christopher Ellis, MD
• Heidi Beth Everett, OTR/L
• Kayla Rose Eza, LCSWA
• William Joseph Faircloth, MD
• Kayla Fields
• Kimberly Mallick Fillman, P.A.

• Non-emergency Medical Transport (VAN) in Bolivia, NC
• Providers in Bolivia, NC by specialty
• Non-emergency Medical Transport (VAN) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; 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.