Board of Commissioners of Fayette County

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

BOARD OF COMMISSIONERS OF FAYETTE COUNTY

Practice address

140 Stonewall Ave W
Fayetteville, GA 30214-1520

Phone

(770) 305-5414

Fax

(770) 305-5190

NPI assigned

Sep 14, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Steve Folden

Title

EMS Captain

Phone

(770) 305-5173

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• FAYETTE COUNTY EMS Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635465600000",
    "number": "1790880474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9150",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420029150",
            "telephone_number": "270-744-9600",
            "fax_number": "270-744-8642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 STONEWALL AVE W",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141520",
            "telephone_number": "770-305-5414",
            "fax_number": "770-305-5190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOARD OF COMMISSIONERS OF FAYETTE COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A",
        "authorized_official_last_name": "FOLDEN",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "EMS CAPTAIN",
        "authorized_official_telephone_number": "770-305-5173",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000002648A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAYETTE COUNTY EMS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FAYETTE COUNTY EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sean Franklin Blithe, PT, DPT
• Ashlee Block, PA-C
• Fredric Darnell Blocker, LPC
• Tyra Blocker, RBT
• Blue Ocean Laboratory Services LLC
• Body in Balance Chiropractic & Wellness Center, LLC
• Body Revolution Healthcare Consultants
• Body Therapy by George Massages LLC
• Camille Franncine Bolton, DPT
• Holliann Elizabeth Bolton, CNM

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2021; 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.