Wayne County Ambulance Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

151-01 Issued in GA

Legal business name

WAYNE COUNTY AMBULANCE SERVICE

Practice address

477 W Bay St
Jesup, GA 31545-1223

Phone

(912) 427-5999

Fax

(912) 427-5906

NPI assigned

Dec 13, 2006

Last updated

Jan 22, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Richard Blake Johnson

Title

Director

Phone

(912) 427-5999

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358812800000",
    "number": "1790846665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 270",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315980270",
            "telephone_number": "912-427-5999",
            "fax_number": "912-427-5906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 W BAY ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315451223",
            "telephone_number": "912-427-5999",
            "fax_number": "912-427-5906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE COUNTY AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2013-01-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "BLAKE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "912-427-5999",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "GA",
            "license": "151-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590008778",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000348444A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Walker, PHARMD
• Paula S Walker X
• Jordan Wasdin, PA-C
• Nina Leah Watson, PHARMD
• Wayne Behavorial Health Services
• Wayne County Anesthesia Associates PC
• Wayne County Board of Education
• Wayne County Board of Health
• Wayne County Board of Health
• Wayne Emergency Group LLC

• Land Ambulance in Jesup, GA
• Providers in Jesup, GA by specialty
• Land Ambulance in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2013; 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.