Organization Active NPI

MMT North Carolina, LLC

  • Land Ambulance
  • Arden, NC
National Provider Identifier
1689442261
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
MMT NORTH CAROLINA, LLC
Doing business as
MedTrust
Practice address
55 Bradley Branch Rd
Arden, NC 28704-9472
Phone
(843) 284-6331
Fax
(843) 974-1880
NPI assigned
Dec 13, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Authorized official

Name
Michelle Boyd
Title
Director of Revenue Cycle
Phone
(843) 284-6331

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

55 Bradley Branch Rd
Arden, NC 28704-9472

Mailing address

1014 Bankton Cir Ste 100
Hanahan, SC 29410-2931
Phone (843) 926-0534

Other names 1

  • MedTrust Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240712000892 NC Part B Supplier - Ambulance Service Supplier 2264977404 Practice locations: Arden, NC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2305829MMT North Carolina LLC55 Bradley Branch Road, Arden, NC 28704Certificate of waiverJun 5, 2028

National Provider Directory

National Provider Directory

Locations

55 Bradley Branch Rd
Arden, NC 28704

400 Ridgefield Ct
Ste 203
Asheville, NC 28806

1014 Bankton Cir
Ste 100
Hanahan, SC 29410

NPI Registry JSON

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

{
    "created_epoch": "1702425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1689442261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 BANKTON CIR STE 100",
            "city": "HANAHAN",
            "state": "SC",
            "postal_code": "294102931",
            "telephone_number": "843-926-0534",
            "fax_number": "843-974-1880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 BRADLEY BRANCH RD",
            "city": "ARDEN",
            "state": "NC",
            "postal_code": "287049472",
            "telephone_number": "843-284-6331",
            "fax_number": "843-974-1880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMT NORTH CAROLINA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-13",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-24",
        "status": "A",
        "authorized_official_last_name": "BOYD",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "843-284-6331"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedTrust",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MedTrust",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arden, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.