Organization Active NPI

County of Randolph

  • Land Ambulance
  • Asheboro, NC
National Provider Identifier
1619965274
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
0760578 Issued in NC
Legal business name
COUNTY OF RANDOLPH
Practice address
760 New Century Dr
Asheboro, NC 27205-7371
Phone
(336) 318-6911
Fax
(336) 636-7503
NPI assigned
Oct 7, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Authorized official

Name
Donovan Lane Davis
Title
Emergency Services Director
Phone
(336) 318-6943

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 0760578 NC Primary

Addresses

Primary practice location

760 New Century Dr
Asheboro, NC 27205-7371

Mailing address

760 New Century Dr
Asheboro, NC 27205-7371
Phone (336) 318-6911

Other identifiers 2

IdentifierTypeStateIssuer
3406754MedicaidNC
07253OtherNCBC/BS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111110000047 NC Part B Supplier - Ambulance Service Supplier 0345413225 Practice locations: Asheboro, NC

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
County of Randolph7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

725 McDowell Rd
Asheboro, NC 27205

2925 Zoo Pkwy
Asheboro, NC 27205
Phone (336) 633-7600

152 N Fayetteville St
Asheboro, NC 27203
Phone (336) 318-6911

760 New Century Dr
Asheboro, NC 27205
Phone (336) 318-6516

501 Pointe South Dr
Randleman, NC 27317
Phone (336) 495-2800

NPI Registry JSON

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747180800000",
    "number": "1619965274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 NEW CENTURY DR",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272057371",
            "telephone_number": "336-318-6911",
            "fax_number": "336-636-7503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 NEW CENTURY DR",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272057371",
            "telephone_number": "336-318-6911",
            "fax_number": "336-636-7503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF RANDOLPH",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-07",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "DONOVAN",
        "authorized_official_middle_name": "LANE",
        "authorized_official_title_or_position": "EMERGENCY SERVICES DIRECTOR",
        "authorized_official_telephone_number": "336-318-6943"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NC",
            "license": "0760578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3406754",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "07253",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; 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.