Edward N Gatlin, ETC

Primary specialty

DriverTaxonomy code 172A00000X

License

801615243 Issued in MS

Practice address

20 Otis LN
Foxworth, MS 39483-3102

Phone

(601) 467-0848

NPI assigned

Dec 7, 2018

Last updated

Dec 7, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Mr. Edward N Gatlin Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• E&J Transportation

  • Non-emergency Medical Transport (VAN)
  • Foxworth, MS
  • NPI 1386116648
  NPD (past) Authorized official

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

{
    "created_epoch": "1544140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544140800000",
    "number": "1437620085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 OTIS LN",
            "city": "FOXWORTH",
            "state": "MS",
            "postal_code": "394833102",
            "telephone_number": "601-467-0848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 OTIS LN",
            "city": "FOXWORTH",
            "state": "MS",
            "postal_code": "394833102",
            "telephone_number": "601-467-0848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATLIN",
        "first_name": "EDWARD",
        "middle_name": "N",
        "credential": "ETC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-12-07",
        "last_updated": "2018-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "MS",
            "license": "801615243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE",
            "identifier": "801615243",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX EIN NUMBER",
            "identifier": "832-374-5638",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDWARD",
            "last_name": "GATLIN",
            "middle_name": "N",
            "prefix": "MR.",
            "credential": "E & J TRANSPORTATION",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Claudette Edwards, M.S., CCC-SLP
• Farmers Medshoppe LLC
• Victoria Finley, SLP
• Forever Caring Personal Care Services, LLC
• Leah Foxworth, MS, CCC-SLP
• Sarah Kate Giacobbe, M.S., CCC-SLP
• Melissa Gipson, SLP
• Laura Hull, SLP
• Amelia Hutto, M.S., CFY-SLP
• Michael W Johnson, CFNP

• Driver in Foxworth, MS
• Providers in Foxworth, MS by specialty
• Driver in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2018; 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.