NPIMap

Organization Active NPI

Tift County Commissioner of Roads & Revenues

Doing business as Tift County EMS

  • Ambulance
  • Tifton, GA
National Provider Identifier
1356447536
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
13701 Issued in GA
Legal business name
TIFT COUNTY COMMISSIONER OF ROADS & REVENUES
Doing business as
Tift County EMS
Practice address
1209 N Tifton Avenue
Tifton, GA 31793
Phone
(229) 386-7924
Fax
(229) 386-7923
NPI assigned
Sep 15, 2006
Last updated
Sep 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Authorized official

Name
Michael Chafin
Title
EMS Director
Phone
(229) 388-6041

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 13701 GA Primary

Addresses

Primary practice location

1209 N Tifton Avenue
Tifton, GA 31793

Mailing address

PO Box 1980
Tifton, GA 31793-1980
Phone (229) 386-7924

Other identifiers 2

IdentifierTypeStateIssuer
000003077AMedicaidGA
85028359AAOtherGAMEDICARE PTAN

Other names 1

  • Tift County EMS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041004001109 GA Part B Supplier - Ambulance Service Supplier 3375502578 Practice locations: Tifton, GA

National Provider Directory

National Provider Directory

Locations

1209 Tift Ave N
Tifton, GA 31794
Phone (229) 386-7924

216 Tift Ave N
Tifton, GA 31794
Phone (912) 386-7924

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1356447536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1980",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317931980",
            "telephone_number": "229-386-7924",
            "fax_number": "229-386-7923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 N TIFTON AVENUE",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "31793",
            "telephone_number": "229-386-7924",
            "fax_number": "229-386-7923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIFT COUNTY COMMISSIONER OF ROADS & REVENUES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "CHAFIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "EMS DIRECTOR",
        "authorized_official_telephone_number": "229-388-6041"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "GA",
            "license": "13701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000003077A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "85028359AA",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tift County EMS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tift County EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tifton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.