Essential Transport Providers LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

ESSENTIAL TRANSPORT PROVIDERS LLC

Practice address

2245 Godby Rd Ste 130
College Park, GA 30349-5059

Phone

(779) 925-5339

Fax

(866) 798-8989

NPI assigned

May 9, 2022

Organization subpart

No

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

Authorized official

Name

Larry Kelly

Title

Cfo

Phone

(904) 504-5529

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

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

{
    "created_epoch": "1652054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777852800000",
    "number": "1538805940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 GODBY RD STE 130",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303495059",
            "telephone_number": "770-925-5339",
            "fax_number": "866-798-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2245 GODBY RD STE 130",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303495059",
            "telephone_number": "779-925-5339",
            "fax_number": "866-798-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSENTIAL TRANSPORT PROVIDERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-09",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "904-504-5529"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343800000X",
            "taxonomy_group": "",
            "desc": "Secured Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003299820A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Faith Pharmacy Inc
• Miranda L. Fallen-Bobo, LPC, NCC

• Land Ambulance in College Park, GA
• Providers in College Park, GA by specialty
• Land Ambulance in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; 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.