Active NPI
Irwin County EMS
- Land Ambulance
- Ocilla, GA
National Provider Identifier
1831231216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- Legal business name
- IRWIN COUNTY EMS
- Practice address
- 108 Cotton Drive
Ocilla, GA 31774-0501 - Phone
- (229) 468-9594
- Fax
- (229) 468-9673
- NPI assigned
- Feb 13, 2007
- Last updated
- Feb 5, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jerry W Edwards
- Title
- Director
- Phone
- (229) 468-9594
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 077-01 | GA | |
| Land Ambulance | 3416L0300X | Primary |
Addresses
Primary practice location
108 Cotton Drive
Ocilla, GA 31774-0501
Mailing address
PO Box 501
Ocilla, GA 31774-0501
Phone (229) 468-9594
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 198047 | Other | GA | BCBS OF GA |
| 590014503 | Other | GA | RAILROAD MEDICARE |
| 000153205A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041006000139 | GA | Part B Supplier - Ambulance Service Supplier | 9739148727 | Practice locations: Ocilla, GA |
National Provider Directory
National Provider DirectoryLocations
107 E 3rd St
Ocilla, GA 31774
Phone (912) 468-9594
108 Cotton Dr
Ocilla, GA 31774
Phone (229) 468-9594
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1360022400000",
"number": "1831231216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 501",
"city": "OCILLA",
"state": "GA",
"postal_code": "317740501",
"telephone_number": "229-468-9594",
"fax_number": "229-468-9673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 COTTON DRIVE",
"city": "OCILLA",
"state": "GA",
"postal_code": "317740501",
"telephone_number": "229-468-9594",
"fax_number": "229-468-9673"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "IRWIN COUNTY EMS",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-13",
"last_updated": "2013-02-05",
"status": "A",
"authorized_official_last_name": "EDWARDS",
"authorized_official_first_name": "JERRY",
"authorized_official_middle_name": "W",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "229-468-9594"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "GA",
"license": "077-01",
"primary": false
},
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF GA",
"identifier": "198047",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "590014503",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000153205A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ocilla, GA
- Ich Physician Group (Irwin Family Medicine)
- Ich Physician Group
- Ich Physician Group (Irwin Surgical Medical)
- Irwin County Anesthesia, Inc.
- Irwin County Board of Education
- Irwin County Hospital (Irwin Pediatrics)
- Irwin County Hospital
- Irwin County Hospital (Palemon Gaskins Memorial Nursing Home)
- Irwin County Hospital (Irwin General Surgery)
- Irwin Specialty Centers LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.