Organization Active NPI

Ultimate Medical Transport LLC

  • Land Ambulance
  • Decatur, GA
National Provider Identifier
1699658484
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
ULTIMATE MEDICAL TRANSPORT LLC
Practice address
5026 Snapfinger Woods Dr
Decatur, GA 30035-4063
Phone
(678) 622-2538
NPI assigned
Jul 29, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Authorized official

Name
Keren Rogers
Title
Owner
Phone
(678) 860-4253

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

5026 Snapfinger Woods Dr
Decatur, GA 30035-4063

Mailing address

2605 Kinnett Dr SW
Lilburn, GA 30047-5709
Phone (678) 622-2538

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260421003026 GA Part B Supplier - Ambulance Service Supplier 2163998691 Practice locations: Decatur, GA

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
11D2310658Ultimate Medical Transport LLC5026 Snapfinger Woods Drive, Stonecrest, GA 30035Certificate of waiverSep 7, 2026

National Provider Directory

National Provider Directory

Locations

5026 Snapfinger Woods Dr
Decatur, GA 30035
Phone (678) 499-1782

NPI Registry JSON

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

{
    "created_epoch": "1753747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753747200000",
    "number": "1699658484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 KINNETT DR SW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300475709",
            "telephone_number": "678-622-2538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5026 SNAPFINGER WOODS DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300354063",
            "telephone_number": "678-622-2538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTIMATE MEDICAL TRANSPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-29",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "KEREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-860-4253"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.