Organization Active NPI

EMS

  • Nursing Care Agency
  • Fayetteville, GA
National Provider Identifier
1376878223
Registry record updated Oct 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
License
434157984A Issued in GA
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 STAFFINGAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 10, 2009

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
434157984AMedicaidGA

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.

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.

Verify at the official NPI Registry.