King George County

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

KING GEORGE COUNTY

Doing business as

King George County Department of Fire, Rescue, & Emergency Services

Practice address

10459 Courthouse Dr
Ste 200
King George, VA 22485-3865

Phone

(540) 775-9181

NPI assigned

Aug 5, 2007

Last updated

Feb 3, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David Wayne Moody

Title

Chief

Phone

(540) 775-8910

Specialties & licenses 2

Addresses

Other names 2

• King George County Department of Fire, Rescue, & Emergency Services Doing business as
• King George Co Dept of Emergency Services Other name

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612310400000",
    "number": "1336330539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8122 KINGS HWY",
            "city": "KING GEORGE",
            "state": "VA",
            "postal_code": "224857051",
            "telephone_number": "540-775-9181",
            "fax_number": "540-775-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10459 COURTHOUSE DR",
            "address_2": "STE 200",
            "city": "KING GEORGE",
            "state": "VA",
            "postal_code": "224853865",
            "telephone_number": "540-775-9181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8122 Kings Hwy",
            "address_purpose": "LOCATION",
            "city": "King George",
            "state": "VA",
            "postal_code": "224857051",
            "country_code": "US",
            "telephone_number": "540-775-9181",
            "fax_number": "540-775-9060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KING GEORGE COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A",
        "authorized_official_last_name": "MOODY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "540-775-8910"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "VA",
            "license": "1013",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "King George County Department of Fire, Rescue, & Emergency Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "King George Co Dept of Emergency Services",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "King George Co Dept of Emergency Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Courtney Keener
• Meghan Reilly Kelley, MSW
• Edwin Charles Khonyongwa, LALFA, LPN
• Bawul Kim
• Min Seong Kim, DMD
• King George County Schools
• King George Dental LLC
• King George Family Doctors, LLC
• King George Life Care, LLC (Heritage Hall - King George)
• King George Life Care, LLC (Heritage Hall - King George)

• Land Ambulance in King George, VA
• Providers in King George, VA by specialty
• Land Ambulance in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; 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.