NPIMap

Organization Active NPI

Adventist Health System Georgia, Inc.

Doing business as AdventHealth Murray EMS

  • Land Ambulance
  • Chatsworth, GA
National Provider Identifier
1669867487
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
0105125 Issued in GA
Legal business name
ADVENTIST HEALTH SYSTEM GEORGIA, INC.
Doing business as
AdventHealth Murray EMS
Practice address
707 Old Dalton Ellijay Rd
Chatsworth, GA 30705-2029
Phone
(706) 517-4564
Fax
(706) 517-2076
NPI assigned
Mar 30, 2015
Last updated
Feb 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Authorized official

Name
Christopher Self
Title
President/Ceo
Phone
(706) 879-4710

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 0105125 GA Primary

Addresses

Primary practice location

707 Old Dalton Ellijay Rd
Chatsworth, GA 30705-2029

Mailing address

707 Old Dalton Ellijay Rd
Chatsworth, GA 30705-2029
Phone (706) 517-4564

Other names 2

  • AdventHealth Murray EMS Doing business as
  • Murray Medical Center Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151118000434 GA Part B Supplier - Ambulance Service Supplier 0840251336 Practice locations: Chatsworth, GA

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Calhoun Family Medical7 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.

NPI Registry JSON

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

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676937600000",
    "number": "1669867487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 OLD DALTON ELLIJAY RD",
            "city": "CHATSWORTH",
            "state": "GA",
            "postal_code": "307052029",
            "telephone_number": "706-517-4564",
            "fax_number": "706-517-2076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 OLD DALTON ELLIJAY RD",
            "city": "CHATSWORTH",
            "state": "GA",
            "postal_code": "307052029",
            "telephone_number": "706-517-4564",
            "fax_number": "706-517-2076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST HEALTH SYSTEM GEORGIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-30",
        "last_updated": "2023-02-21",
        "certification_date": "2022-03-07",
        "status": "A",
        "authorized_official_last_name": "SELF",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "706-879-4710"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "GA",
            "license": "0105125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AdventHealth Murray EMS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Murray Medical Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Chatsworth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; 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.