Schley County Commissioner

Primary specialty

AmbulanceTaxonomy code 341600000X

License

12301 Issued in GA

Legal business name

SCHLEY COUNTY COMMISSIONER

Doing business as

SCHLEY COUNTY EMS

Practice address

106 North Pecan Street
Ellaville, GA 31806

Phone

(229) 942-3375

Fax

(229) 937-5880

NPI assigned

Sep 15, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Duane Montgomery

Title

EMS Director

Phone

(229) 942-3375

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• SCHLEY COUNTY EMS Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373241600000",
    "number": "1205932381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 NORTH PECAN STREET",
            "city": "ELLAVILLE",
            "state": "GA",
            "postal_code": "31806",
            "telephone_number": "229-942-3375",
            "fax_number": "229-937-5880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 NORTH PECAN STREET",
            "city": "ELLAVILLE",
            "state": "GA",
            "postal_code": "31806",
            "telephone_number": "229-942-3375",
            "fax_number": "229-937-5880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHLEY COUNTY COMMISSIONER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2013-07-08",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "DUANE",
        "authorized_official_title_or_position": "EMS DIRECTOR",
        "authorized_official_telephone_number": "229-942-3375",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "GA",
            "license": "12301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000207611A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "85033859AA",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SCHLEY COUNTY EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Phoebe Sumter Medical Center, Inc
• Angelita Reyes Quiroz, NP-C
• Laura Noel Register
• Sandra Reynolds
• Schley County Board of Health
• Schley County Schools
• Maryanne Shephard, NURSE PRACTIONER
• Kristy Joy Smith, FNP-C
• Laci Smith, RN
• Southwest Ga Primary Care, LLC

• Ambulance in Ellaville, GA
• Providers in Ellaville, GA by specialty
• Ambulance in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2013; 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.