Organization Active NPI

Mutual Care EMS LLC

  • Land Ambulance
  • Atlanta, GA
National Provider Identifier
1487364386
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
MUTUAL CARE EMS LLC
Practice address
615 Sable View LN
Atlanta, GA 30349-3699
Phone
(404) 692-3603
NPI assigned
Dec 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Authorized official

Name
Jamesia Edge
Title
Owner
Phone
(404) 692-3603

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

615 Sable View LN
Atlanta, GA 30349-3699

Mailing address

615 Sable View LN
Atlanta, GA 30349-3699
Phone (404) 692-3603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230911001639 GA Part B Supplier - Ambulance Service Supplier 7315301371 Practice locations: Stockbridge, GA

National Provider Directory

National Provider Directory

Locations

5353 N Henry Blvd
Ste 113
Stockbridge, GA 30281
Phone (404) 282-8878

NPI Registry JSON

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

{
    "created_epoch": "1669852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669852800000",
    "number": "1487364386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 SABLE VIEW LN",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303493699",
            "telephone_number": "404-692-3603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 SABLE VIEW LN",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303493699",
            "telephone_number": "404-692-3603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUTUAL CARE EMS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-01",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A",
        "authorized_official_last_name": "EDGE",
        "authorized_official_first_name": "JAMESIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-692-3603"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; 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.