NPIMap

Organization Active NPI

County of Duplin

Doing business as Duplin County Emergency Medical Services

  • Land Ambulance
  • Kenansville, NC
National Provider Identifier
1508919069
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
COUNTY OF DUPLIN
Doing business as
Duplin County Emergency Medical Services
Practice address
209 Seminary Street
Kenansville, NC 28349-0000
Phone
(910) 296-2160
Fax
(910) 296-2164
NPI assigned
Jan 19, 2007
Last updated
Mar 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Authorized official

Name
Brandon McMahon
Title
Director of Emergency Services
Phone
(910) 372-9212

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 1079 NC
Land Ambulance 3416L0300X NU Primary
Paramedic 146L00000X 0310103 NC

Addresses

Primary practice location

209 Seminary Street
Kenansville, NC 28349-0000

Mailing address

PO Box 909
209 Seminary Street
Kenansville, NC 28349-0909
Phone (910) 296-2160

Other identifiers 2

IdentifierTypeStateIssuer
3406618MedicaidNC
07250OtherNCBLUE CROSS BLUE SHIELD

Other names 1

  • Duplin County Emergency Medical Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100324001114 NC Part B Supplier - Ambulance Service Supplier 1456341536 Practice locations: Kenansville, NC

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

  • County of Duplin

    dba Duplin County Health Services

    • State or Local Public Health Clinic/Center
    • Kenansville, NC
    • NPI 1235198177

    1456341536

    Same PAC ID

National Provider Directory

National Provider Directory
Tax ID family
County of Duplin4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

  • County of Duplin

    dba Duplin County Department of Social Services

    • Case Management Agency
    • Kenansville, NC
    • NPI 1104166883
    NPD tax ID
  • County of Duplin

    dba Duplin County Health Services

    • State or Local Public Health Clinic/Center
    • Kenansville, NC
    • NPI 1235198177
    NPD tax ID
  • County of Duplin

    dba Duplin County Public Transportation

    • Non-emergency Medical Transport (VAN)
    • Kenansville, NC
    • NPI 1588905269
    NPD tax ID

Locations

209 Seminary St
Kenansville, NC 28349
Phone (910) 296-2160

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710374400000",
    "number": "1508919069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "address_2": "209 SEMINARY STREET",
            "city": "KENANSVILLE",
            "state": "NC",
            "postal_code": "283490909",
            "telephone_number": "910-296-2160",
            "fax_number": "910-296-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 SEMINARY STREET",
            "city": "KENANSVILLE",
            "state": "NC",
            "postal_code": "283490000",
            "telephone_number": "910-296-2160",
            "fax_number": "910-296-2164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF DUPLIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2024-03-14",
        "certification_date": "2023-12-11",
        "status": "A",
        "authorized_official_last_name": "MCMAHON",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "DIRECTOR OF EMERGENCY SERVICES",
        "authorized_official_telephone_number": "910-372-9212"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NC",
            "license": "1079",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "146L00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Paramedic",
            "state": "NC",
            "license": "0310103",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3406618",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "07250",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Duplin County Emergency Medical Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kenansville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; 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.