Lifecare Medical Transports, LLC

Primary specialty

AmbulanceTaxonomy code 341600000X

License

00749 Issued in VA

Legal business name

LIFECARE MEDICAL TRANSPORTS, LLC

Practice address

1170 International Pkwy
Fredericksburg, VA 22406-1126

Phone

(540) 752-7721

Fax

(540) 752-5194

NPI assigned

Mar 15, 2006

Organization subpart

No

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

Authorized official

Name

Robert A Jewell

Title

Chief Revenue Integration Officer

Phone

(844) 597-4911

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• LifeCare Medical Transports, Inc. Former legal business name

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1396714101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7152",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601977152",
            "telephone_number": "844-597-4911",
            "fax_number": "866-687-2796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 INTERNATIONAL PKWY",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224061126",
            "telephone_number": "540-752-7721",
            "fax_number": "540-752-5194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFECARE MEDICAL TRANSPORTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-15",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A",
        "authorized_official_last_name": "JEWELL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF REVENUE INTEGRATION OFFICER",
        "authorized_official_telephone_number": "844-597-4911"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "VA",
            "license": "00749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "020215",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009010068",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeCare Medical Transports, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Ambulance in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Ambulance in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.