NPIMap

Organization Active NPI

County of Wilkes

  • Land Ambulance
  • Wilkesboro, NC
National Provider Identifier
1669539458
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
1266 Issued in NC
Legal business name
COUNTY OF WILKES
Practice address
204 Call St
Wilkesboro, NC 28697-2949
Phone
(336) 651-7365
Fax
(336) 651-7500
NPI assigned
Jan 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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

Authorized official

Name
Mr. Jason Reavis
Title
Emergency Services Director
Phone
(336) 651-7363

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 1266 NC Primary

Addresses

Primary practice location

204 Call St
Wilkesboro, NC 28697-2949

Mailing address

204 Call St
Wilkesboro, NC 28697-2949
Phone (336) 651-7365

Other identifiers 2

IdentifierTypeStateIssuer
0723POtherNCBCBSNC
3406633MedicaidNC

Other names 1

  • Wilkes County Emergency Medical Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090421000344 NC Part B Supplier - Ambulance Service Supplier 2668529157 Practice locations: Hays, NC; Millers Creek, NC; Ronda, NC; Wilkesboro, 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 Wilkes5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

1372 W D St
North Wilkesboro, NC 28659
Phone (919) 651-7366

204 Call St
Wilkesboro, NC 28697
Phone (336) 651-7363

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763078400000",
    "number": "1669539458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 CALL ST",
            "city": "WILKESBORO",
            "state": "NC",
            "postal_code": "286972949",
            "telephone_number": "336-651-7365",
            "fax_number": "336-651-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 CALL ST",
            "city": "WILKESBORO",
            "state": "NC",
            "postal_code": "286972949",
            "telephone_number": "336-651-7365",
            "fax_number": "336-651-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF WILKES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A",
        "authorized_official_last_name": "REAVIS",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "EMERGENCY SERVICES DIRECTOR",
        "authorized_official_telephone_number": "336-651-7363",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NC",
            "license": "1266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "0723P",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3406633",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wilkes County Emergency Medical Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wilkes County Emergency Medical Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilkesboro, NC

Sources for this page

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