Active NPI
Elite Ambulance LLC
- Land Ambulance
- Lebanon, TN
National Provider Identifier
1528417060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- Legal business name
- ELITE AMBULANCE LLC
- Practice address
- 228 W Main St Ste D
Lebanon, TN 37087-2681 - Phone
- (615) 656-4777
- Fax
- (615) 656-4471
- NPI assigned
- Jun 6, 2016
- 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
- David T Henderlight
- Title
- President
- Phone
- (615) 656-4477
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | TN | Primary |
Addresses
Primary practice location
228 W Main St Ste D
Lebanon, TN 37087-2681
Mailing address
PO Box 1597
Lebanon, TN 37088-1597
Phone (615) 656-4477
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190726002143 | TN | Part B Supplier - Ambulance Service Supplier | 1658607742 | Practice locations: Lebanon, TN |
National Provider Directory
National Provider DirectoryLocations
228 W Main St
Ste D
Lebanon, TN 37087
Phone (615) 656-4477
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465171200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1724803200000",
"number": "1528417060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1597",
"city": "LEBANON",
"state": "TN",
"postal_code": "370881597",
"telephone_number": "615-656-4477",
"fax_number": "615-656-4471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "228 W MAIN ST STE D",
"city": "LEBANON",
"state": "TN",
"postal_code": "370872681",
"telephone_number": "615-656-4777",
"fax_number": "615-656-4471"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ELITE AMBULANCE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2016-06-06",
"last_updated": "2024-08-28",
"certification_date": "2024-08-28",
"status": "A",
"authorized_official_last_name": "HENDERLIGHT",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "T",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "615-656-4477"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "TN",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, TN
- Ec Lebanon Operations, LLC (Elmcroft of Lebanon)
- Derrick Edwards, LPC-MHSP
- Kennedy Ellen Eidenire, PMHNP
- Robert Chaffee Elam
- Elevate Medical Center, PLLC
- Elite Sports Medicine and Orthopaedic Center, PLC
- Elite Sports Medicine and Orthopaedic Center, PLC
- Alexander Brice Elkins
- Desiree Ellison, FNP-C
- Employment & Assessment Solutions, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.