Lifeway Medical Transport,LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

LIFEWAY MEDICAL TRANSPORT,LLC

Practice address

5637 Memorial Dr
Virginia Beach, VA 23455-3875

Phone

(757) 937-8162

Fax

(757) 524-5024

NPI assigned

Jun 19, 2019

Last updated

Jan 12, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marquis Thompson

Title

Owner

Phone

(757) 937-8162

Specialties & licenses 2

Addresses

Other names 1

• LifeWay Medical Transport,LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

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

{
    "created_epoch": "1560902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705017600000",
    "number": "1538729785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5637 MEMORIAL DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234553875",
            "telephone_number": "757-937-8162",
            "fax_number": "757-524-5024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5637 MEMORIAL DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234553875",
            "telephone_number": "757-937-8162",
            "fax_number": "757-524-5024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEWAY MEDICAL TRANSPORT,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-19",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "MARQUIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-937-8162"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeWay Medical Transport,LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "LifeWay Medical Transport,LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Land Ambulance in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Land Ambulance in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.