Organization Active NPI

1St Class Ambulance

  • Land Ambulance
  • Atlanta, GA
National Provider Identifier
1750908372
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
1ST CLASS AMBULANCE
Practice address
2131 Calverton LN SW
Atlanta, GA 30331-7889
Phone
(404) 392-0108
NPI assigned
Jun 30, 2020
Last updated
Jun 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Authorized official

Name
Mr. Dwayne Brown, PARAMEDIC
Title
Owner
Phone
(404) 392-0108

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

2131 Calverton LN SW
Atlanta, GA 30331-7889

Mailing address

2131 Calverton LN SW
Atlanta, GA 30331-7889
Phone (404) 392-0108

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220126002539 GA Part B Supplier - Ambulance Service Supplier 1456743319 Practice locations: Fayetteville, GA

National Provider Directory

National Provider Directory

Locations

175 Walter Way
#B
Fayetteville, GA 30214
Phone (404) 392-0108

NPI Registry JSON

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

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687824000000",
    "number": "1750908372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2131 CALVERTON LN SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303317889",
            "telephone_number": "404-392-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 CALVERTON LN SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303317889",
            "telephone_number": "404-392-0108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1ST CLASS AMBULANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-30",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "DWAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-392-0108",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PARAMEDIC"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.