Angel EMS LLC

Primary specialty

AmbulanceTaxonomy code 341600000X

License

023-05 Issued in GA

Legal business name

ANGEL EMS LLC

Practice address

337 S Cedar LN
Ft Oglethorpe, GA 30742-3378

Phone

(706) 861-1234

Fax

(706) 375-8209

NPI assigned

Mar 14, 2007

Last updated

Jun 7, 2016By 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

Mrs. Sheri Wilson

Title

Owner

Phone

(706) 861-1234

Specialties & licenses 1

Addresses

Other identifiers 8

Locations

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465257600000",
    "number": "1679606040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "337 S CEDAR LN",
            "address_2": "PO BOX 5495",
            "city": "FT OGLETHORPE",
            "state": "GA",
            "postal_code": "307423378",
            "telephone_number": "706-861-1234",
            "fax_number": "706-375-8209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "337 S CEDAR LN",
            "city": "FT OGLETHORPE",
            "state": "GA",
            "postal_code": "307423378",
            "telephone_number": "706-861-1234",
            "fax_number": "706-375-8209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL EMS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2016-06-07",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "SHERI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-861-1234",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "GA",
            "license": "023-05",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4582291",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "590012945",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000823259A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "81016",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHSPRING",
            "identifier": "1430581",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENN CARE",
            "identifier": "4117030",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "52665555",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "4002438",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ambulance in Fort Oglethorpe, GA
• Providers in Fort Oglethorpe, GA by specialty
• Ambulance in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.