NPIMap

Organization Active NPI

Grady Memorial Hospital Corporation

Doing business as Grady EMS

  • Land Ambulance
  • Atlanta, GA
National Provider Identifier
1891966578
Registry record updated May 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
060-30 Issued in GA
Legal business name
GRADY MEMORIAL HOSPITAL CORPORATION
Doing business as
Grady EMS
Practice address
80 Jesse Hill Jr Drive SE
Box 26042
Atlanta, GA 30303-3050
Phone
(404) 616-8880
NPI assigned
Mar 20, 2008
Last updated
May 18, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2011

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

Authorized official

Name
Ms. Ozzie Gilbert
Title
VP Finance
Phone
(404) 616-1796

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 060-30 GA Primary

Addresses

Primary practice location

80 Jesse Hill Jr Drive SE
Box 26042
Atlanta, GA 30303-3050

Mailing address

80 Jesse Hill Jr Drive SE
Box 26042
Atlanta, GA 30303-3050
Phone (404) 616-8880

Other identifiers 1

IdentifierTypeStateIssuer
000000855BMedicaidGA

Other names 1

  • GRADY EMS Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110711000595 GA Part B Supplier - Ambulance Service Supplier 7517032998 Practice locations: Atlanta, GA; Bainbridge, GA

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Grady Health System15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

80 Jesse Hill Jr Dr SE
#26042
Atlanta, GA 30303
Phone (404) 616-8880

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Crestview Health & Rehabilitation CenterAtlanta, GA, CCN 115525 Skilled nursing facility Operational/Managerial Control Apr 22, 2008

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305676800000",
    "number": "1891966578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 JESSE HILL JR DRIVE SE",
            "address_2": "BOX 26042",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033050",
            "telephone_number": "404-616-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 JESSE HILL JR DRIVE SE",
            "address_2": "BOX 26042",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033050",
            "telephone_number": "404-616-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRADY MEMORIAL HOSPITAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-20",
        "last_updated": "2011-05-18",
        "status": "A",
        "authorized_official_last_name": "GILBERT",
        "authorized_official_first_name": "OZZIE",
        "authorized_official_title_or_position": "VP  FINANCE",
        "authorized_official_telephone_number": "404-616-1796",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "GA",
            "license": "060-30",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000000855B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRADY EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.