Organization Active NPI

Lifeguard Ambulance Service of Tennessee LLC

  • Ambulance
  • Nashville, TN
National Provider Identifier
1871592139
Registry record updated Nov 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
EMS0000010028 Issued in TN
Legal business name
LIFEGUARD AMBULANCE SERVICE OF TENNESSEE LLC
Practice address
1933 Elm Tree Dr
Nashville, TN 37210-3717
Phone
(615) 724-1911
Fax
(615) 724-1048
NPI assigned
Jul 19, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2010

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

Authorized official

Name
Mr. John W Roche
Title
Ceo President
Phone
(205) 380-2065

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X EMS0000010028 TN Primary

Addresses

Primary practice location

1933 Elm Tree Dr
Nashville, TN 37210-3717

Mailing address

P.O. Box 11361
Birmingham, AL 35202-1361
Phone (205) 380-2065

Other identifiers 1

IdentifierTypeStateIssuer
3574708MedicaidTN

National Provider Directory

National Provider Directory

Locations

3026 Lafayette Rd
Fort Oglethorpe, GA 30742
Phone (205) 380-2065

1933 Elm Tree Dr
Nashville, TN 37210
Phone (205) 380-2065

2913 Armory Dr
Nashville, TN 37204
Phone (615) 724-1911

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289347200000",
    "number": "1871592139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 11361",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352021361",
            "telephone_number": "205-380-2065",
            "fax_number": "205-380-2074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1933 ELM TREE DR",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372103717",
            "telephone_number": "615-724-1911",
            "fax_number": "615-724-1048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEGUARD AMBULANCE SERVICE OF TENNESSEE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-19",
        "last_updated": "2010-11-10",
        "status": "A",
        "authorized_official_last_name": "ROCHE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO PRESIDENT",
        "authorized_official_telephone_number": "205-380-2065",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "TN",
            "license": "EMS0000010028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3574708",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2010; 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.