Active NPI
EMS
- Nursing Care Agency
- Fayetteville, GA
National Provider Identifier
1376878223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Care Agency
- License
- 434157984A
- Legal business name
- EMS
- Practice address
- 500 W Lanier Ave
Ste 410
Fayetteville, GA 30214-7636 - Phone
- (678) 817-6200
- Fax
- (770) 719-5263
- NPI assigned
- Oct 10, 2009
- Organization subpart
- Yes
- Parent organization
- E MEDICAL STAFFING
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tracy Pearson
- Title
- Owner
- Phone
- (678) 907-5104
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Care Agency | 251J00000X | 434157984A | GA | Primary |
Addresses
Primary practice location
500 W Lanier Ave
Ste 410
Fayetteville, GA 30214-7636
Mailing address
500 W Lanier Ave
Ste 410
Fayetteville, GA 30214-7636
Phone (678) 817-6200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 434157984A | Medicaid | GA |
National Provider Directory
National Provider Directory- Part of
- E Medical Staffing
Locations
500 Lanier Ave W
Ste 410
Fayetteville, GA 30214
Phone (678) 817-6200
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Registered Nurse
- Hampton, GA
- NPI 1174700553
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255132800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1255132800000",
"number": "1376878223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 W LANIER AVE",
"address_2": "STE 410",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302147636",
"telephone_number": "678-817-6200",
"fax_number": "770-719-5263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 W LANIER AVE",
"address_2": "STE 410",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302147636",
"telephone_number": "678-817-6200",
"fax_number": "770-719-5263"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EMS",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "E MEDICAL STAFFING",
"enumeration_date": "2009-10-10",
"last_updated": "2009-10-10",
"status": "A",
"authorized_official_last_name": "PEARSON",
"authorized_official_first_name": "TRACY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "678-907-5104"
},
"taxonomies": [
{
"code": "251J00000X",
"taxonomy_group": "",
"desc": "Nursing Care",
"state": "GA",
"license": "434157984A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "434157984A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fayetteville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.