Active NPI
Mutual Care EMS LLC
- Land Ambulance
- Atlanta, GA
National Provider Identifier
1487364386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230911001639 | GA | Part B Supplier - Ambulance Service Supplier | 7315301371 | Practice locations: Stockbridge, GA |
National Provider Directory
National Provider DirectoryLocations
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.