Jackson Emergency Transport Service, LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

552 Issued in AL

Legal business name

JACKSON EMERGENCY TRANSPORT SERVICE, LLC

Practice address

133 Court St
Grove Hill, AL 36451-3228

Phone

(601) 422-7281

NPI assigned

Aug 24, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Kevin Smith, EMT-P

Title

Manager

Phone

(614) 422-7281

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625788800000",
    "number": "1831206713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2037",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394422037",
            "telephone_number": "601-422-7281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 COURT ST",
            "city": "GROVE HILL",
            "state": "AL",
            "postal_code": "364513228",
            "telephone_number": "601-422-7281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON EMERGENCY TRANSPORT SERVICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "614-422-7281",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "EMT-P"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "AL",
            "license": "552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51050479",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200013112",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tonya Kaye Hinote, RN
• David M Hubbs, MD
• Mary Ellen Huckabee, CRNP
• Ihp Al ER PLLC
• Insight Treatment Program, Inc
• Andrea Johnson, DMD
• Allen Hugh Jordan, RPH
• Kate Powell Jordan (The Medicine Chest)
• Bessie King, RN
• Debbie Harris Larose, R.PH.

• Land Ambulance in Grove Hill, AL
• Providers in Grove Hill, AL by specialty
• Land Ambulance in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2021; 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.