NPIMap

Organization Active NPI

County of Davie

Doing business as Davie County EMS

  • Land Ambulance
  • Mocksville, NC
National Provider Identifier
1790728319
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
1077 Issued in NC
Legal business name
COUNTY OF DAVIE
Doing business as
Davie County EMS
Practice address
114 Doctor Slate Drive
Mocksville, NC 27028-0935
Phone
(336) 751-0879
Fax
(336) 751-5914
NPI assigned
Jun 13, 2006
Last updated
May 21, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
COUNTY OF DAVIEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Authorized official

Name
Mr. Joseph Ashburn
Title
EMS Director
Phone
(336) 705-1820

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X NC
Land Ambulance 3416L0300X 1077 NC Primary

Addresses

Primary practice location

114 Doctor Slate Drive
Mocksville, NC 27028-0935

Mailing address

114 Doctor Slate Drive
Mocksville, NC 27028-0935
Phone (336) 751-0879

Other names 1

  • Davie County EMS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060928000040 NC Part B Supplier - Ambulance Service Supplier 7416952312 Practice locations: Mocksville, NC

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
34D0713945Davie County Emergency Services114 Doctor Slate Drive, Mocksville, NC 27028Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Davie County Health Dep8 organizations share this tax ID, including this one
Part of
Davie County Health Dep

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716249600000",
    "number": "1790728319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 DOCTOR SLATE DRIVE",
            "city": "MOCKSVILLE",
            "state": "NC",
            "postal_code": "270280935",
            "telephone_number": "336-751-0879",
            "fax_number": "336-751-5914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 DOCTOR SLATE DRIVE",
            "city": "MOCKSVILLE",
            "state": "NC",
            "postal_code": "270280935",
            "telephone_number": "336-751-0879",
            "fax_number": "336-751-5914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF DAVIE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF DAVIE",
        "enumeration_date": "2006-06-13",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A",
        "authorized_official_last_name": "ASHBURN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "EMS DIRECTOR",
        "authorized_official_telephone_number": "336-705-1820",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NC",
            "license": "1077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Davie County EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mocksville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; 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.