Great Vine Medical Transport LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

GREAT VINE MEDICAL TRANSPORT LLC

Practice address

3421 Meadow Grass Dr
Dacula, GA 30019-1360

Phone

(770) 658-0724

NPI assigned

Oct 5, 2026

Last updated

Oct 12, 2026By 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

Hyacinth Idibia

Title

Owner

Phone

(770) 658-0724

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1791158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791763200000",
    "number": "1821992850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 MEADOW GRASS DR",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300191360",
            "telephone_number": "770-658-0724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3421 MEADOW GRASS DR",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300191360",
            "telephone_number": "770-658-0724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT VINE MEDICAL TRANSPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-05",
        "last_updated": "2026-10-12",
        "certification_date": "2026-10-12",
        "status": "A",
        "authorized_official_last_name": "IDIBIA",
        "authorized_official_first_name": "HYACINTH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-658-0724"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Heidi Green, DC
• Jennifer Christine Green, RN
• Lois Green, MA
• Christina Greene, DPT
• Sarah Emily Gregory, LAT, ATC

• Non-emergency Medical Transport (VAN) in Dacula, GA
• Providers in Dacula, GA by specialty
• Non-emergency Medical Transport (VAN) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2026; 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.