Organization Active NPI

Cherokee County Board of Commissioners

  • Land Ambulance
  • Canton, GA
National Provider Identifier
1801972625
Registry record updated Apr 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
028-03 Issued in GA
Legal business name
CHEROKEE COUNTY BOARD OF COMMISSIONERS
Practice address
150 Chattin Dr
Canton, GA 30115-8249
Phone
(678) 614-8957
NPI assigned
Oct 27, 2006
Last updated
Apr 17, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2013

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

Authorized official

Name
Dan West
Title
Chief
Phone
(678) 614-8957

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 028-03 GA Primary

Addresses

Primary practice location

150 Chattin Dr
Canton, GA 30115-8249

Mailing address

N2930 State Road 22
Wautoma, WI 54982-5267
Phone (920) 787-2291

Other identifiers 2

IdentifierTypeStateIssuer
406590727OtherGARAILROAD MEDICARE
000764233BMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040521000775 GA Part B Supplier - Ambulance Service Supplier 3870584477 Practice locations: Canton, GA

National Provider Directory

National Provider Directory

Locations

150 Chattin Dr
Canton, GA 30115
Phone (678) 493-4000

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366156800000",
    "number": "1801972625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N2930 STATE ROAD 22",
            "city": "WAUTOMA",
            "state": "WI",
            "postal_code": "549825267",
            "telephone_number": "920-787-2291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 CHATTIN DR",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158249",
            "telephone_number": "678-614-8957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHEROKEE COUNTY BOARD OF COMMISSIONERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2013-04-17",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "678-614-8957"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "GA",
            "license": "028-03",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "406590727",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000764233B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.