Medport Logistics LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

MEDPORT LOGISTICS LLC

Practice address

301 Green St NW Ste 200R
Gainesville, GA 30501-3360

Phone

(404) 620-1500

NPI assigned

Jul 3, 2025

Last updated

Aug 18, 2025By 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

Jeremy Shane Lord

Title

Owner

Phone

(706) 338-5881

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1751500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755475200000",
    "number": "1891684726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1513",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305031513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 GREEN ST NW STE 200R",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013360",
            "telephone_number": "404-620-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDPORT LOGISTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-03",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A",
        "authorized_official_last_name": "LORD",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "SHANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-338-5881"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Land Ambulance in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.