Active NPI
Key of Life Ambulance Service
- Ambulance
- Macon, GA
National Provider Identifier
1225801533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulance
- Legal business name
- KEY OF LIFE AMBULANCE SERVICE
- Practice address
- 3040 Riverside Dr Ste C1
Macon, GA 31210-0410 - Phone
- (478) 973-5055
- NPI assigned
- Oct 30, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Shekeita Stephens
- Title
- Owner
- Phone
- (478) 973-5055
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | Primary |
Addresses
Primary practice location
3040 Riverside Dr Ste C1
Macon, GA 31210-0410
Mailing address
350 Amanda Dr
Macon, GA 31216-6388
Phone (478) 973-5055
Other names 1
- KEY OF LIFE CARES
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250205003016 | GA | Part B Supplier - Ambulance Service Supplier | 3274063250 | Practice locations: Macon, GA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D2278516 | Key of Life Ambulance Service | Certificate of waiver | Mar 19, 2027 |
National Provider Directory
National Provider DirectoryLocations
3040 Riverside Dr
Ste C1
Macon, GA 31210
Phone (478) 227-2809
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Home Health Certified Respiratory Therapist
- Macon, GA
- NPI 1316283104
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698624000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1698624000000",
"number": "1225801533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 AMANDA DR",
"city": "MACON",
"state": "GA",
"postal_code": "312166388",
"telephone_number": "478-973-5055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3040 RIVERSIDE DR STE C1",
"city": "MACON",
"state": "GA",
"postal_code": "312100410",
"telephone_number": "478-973-5055"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KEY OF LIFE AMBULANCE SERVICE",
"organizational_subpart": "NO",
"enumeration_date": "2023-10-30",
"last_updated": "2023-10-30",
"certification_date": "2023-10-30",
"status": "A",
"authorized_official_last_name": "STEPHENS",
"authorized_official_first_name": "SHEKEITA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "478-973-5055",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "341600000X",
"taxonomy_group": "",
"desc": "Ambulance",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "KEY OF LIFE CARES",
"code": "4",
"type": "Former Legal Business Name"
}
]
}
Other providers in Macon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; 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.