Individual provider Active NPI

Montravious Garrett

  • Non-emergency Medical Transport (VAN)
  • Austell, GA
National Provider Identifier
1396291746
Registry record updated Aug 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
License
057605326 Issued in GA
Practice address
1953 Royal Industrial Blvd
Austell, GA 30106-3651
Phone
(770) 823-5471
NPI assigned
Aug 26, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X 057605326 GA Primary

Addresses

Primary practice location

1953 Royal Industrial Blvd
Austell, GA 30106-3651

Mailing address

2984 Oshields CT SW
Marietta, GA 30060-6377
Phone (770) 823-5471

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
057605326GAMDNon-emergency Medical Transport (VAN)

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Care Medical Transport Non-Emergency Medical Transport (Van) Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1472169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472169600000",
    "number": "1396291746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2984 OSHIELDS CT SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300606377",
            "telephone_number": "770-823-5471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1953 ROYAL INDUSTRIAL BLVD",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301063651",
            "telephone_number": "770-823-5471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRETT",
        "first_name": "MONTRAVIOUS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-26",
        "last_updated": "2016-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "GA",
            "license": "057605326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2016; 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.