Jonathan Pace, EMT-I

Primary specialty

Intermediate Emergency Medical TechnicianTaxonomy code 146M00000X

License

I042897 Issued in GA

Practice address

4683 Redan Rd
Stone Mountain, GA 30083

Phone

(678) 492-5466

NPI assigned

Apr 4, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1554336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554336000000",
    "number": "1790247070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4683 REDAN RD",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "30083",
            "telephone_number": "678-492-5466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4683 REDAN RD",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "30083",
            "telephone_number": "678-492-5466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACE",
        "first_name": "JONATHAN",
        "name_prefix": "Mr.",
        "credential": "EMT-I",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-04",
        "last_updated": "2019-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146M00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Intermediate",
            "state": "GA",
            "license": "I042897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "I042897",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NA",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "NA",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "NA",
            "address_1": "4683 Redan Rd",
            "city": "Stone Mountain",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Intermediate Emergency Medical Technician in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Intermediate Emergency Medical Technician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2019; 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.