Providence Transportation Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

PROVIDENCE TRANSPORTATION INC

Practice address

7385 Ridge Rd
Lexington, NC 27295-5796

Phone

(336) 472-7433

NPI assigned

Jan 2, 2020

Organization subpart

No

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

Authorized official

Name

David Stevens

Title

President

Phone

(336) 508-6322

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

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

{
    "created_epoch": "1577923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577923200000",
    "number": "1376182741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7902 SOUTHERLAND DR",
            "city": "BROWNS SUMMIT",
            "state": "NC",
            "postal_code": "272149564",
            "telephone_number": "336-508-6322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7385 RIDGE RD",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272955796",
            "telephone_number": "336-472-7433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE TRANSPORTATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-02",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-508-6322"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40333552",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Lexington, NC
• Providers in Lexington, NC by specialty
• Land Ambulance in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; 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.