Life Stat EMS

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

LIFE STAT EMS

Practice address

3551 Ball Ground Hwy
Canton, GA 30114-7411

Phone

(404) 987-6278

Fax

(678) 807-2631

NPI assigned

Oct 6, 2021

Organization subpart

No

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

Authorized official

Name

Michael L Waters

Title

Billing Manager

Phone

(770) 490-3911

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": "1633478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642636800000",
    "number": "1942962048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4636",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301140019",
            "telephone_number": "404-987-6278",
            "fax_number": "678-807-2631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 BALL GROUND HWY",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301147411",
            "telephone_number": "404-987-6278",
            "fax_number": "678-807-2631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE STAT EMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-06",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A",
        "authorized_official_last_name": "WATERS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "770-490-3911"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Townley Lewis, DDS
• Evan Michael Lewis, D.P.M.
• Megan Rose Liebmann, BT
• Yee Ling Lieu
• Life of Food LLC
• Alyssa Liguori, D.O.
• Bethany Wiley Lill
• Christina L Liming, MS, CCC-SLP
• Aisha Linge, PHARMD
• Ruximar Hernandez Linkous, DDS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; 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.