PWT Enterprises, Inc.

Primary specialty

AmbulanceTaxonomy code 341600000X

License

10203 Issued in GA

Legal business name

PWT ENTERPRISES, INC.

Doing business as

MedPro EMS

Practice address

21 N Lee St
Forsyth, GA 31029-2114

Phone

(478) 994-2673

Fax

(478) 974-0707

NPI assigned

Dec 27, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Eric Wilson

Title

President

Phone

(478) 994-2673

Specialties & licenses 1

Addresses

Other names 1

• MedPro EMS Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1324944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642723200000",
    "number": "1538438288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 N LEE ST",
            "city": "FORSYTH",
            "state": "GA",
            "postal_code": "310292114",
            "telephone_number": "478-994-2673",
            "fax_number": "478-974-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 N LEE ST",
            "city": "FORSYTH",
            "state": "GA",
            "postal_code": "310292114",
            "telephone_number": "478-994-2673",
            "fax_number": "478-974-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PWT ENTERPRISES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-27",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "478-994-2673",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "GA",
            "license": "10203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedPro EMS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MedPro EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dana A Peterman, PT, DPT
• Chelsea Powell, APRN, FNP-BC
• Pruitthealth - Forsyth, LLC
• Pruitthealth - Monroe, LLC
• Kristen Joyce Puzio, MA
• Queen Consultants, LLC
• Angela Paige Queen, NPC
• Jeffrey M. Quinn, ATC,CSCS,LAT
• Wesley Alexander Ridley, MD
• River Edge Behavioral Health Center

• Ambulance in Forsyth, GA
• Providers in Forsyth, GA by specialty
• Ambulance in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.