Organization Active NPI

Crown EMS LLC

  • Land Ambulance
  • Lawrenceville, GA
National Provider Identifier
1962175083
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
CROWN EMS LLC
Practice address
1400 Herrington Rd Apt 4301
Lawrenceville, GA 30044-2286
Phone
(404) 863-1967
NPI assigned
Jul 26, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Authorized official

Name
Mr. Ovie Osio Crown
Title
Maneger
Phone
(404) 863-1967

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

1400 Herrington Rd Apt 4301
Lawrenceville, GA 30044-2286

Mailing address

1400 Herrington Rd Apt 4301
Lawrenceville, GA 30044-2286

Other names 1

  • CROWN EMS LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240823000431 GA Part B Supplier - Ambulance Service Supplier 8325587249 Practice locations: Lawrenceville, GA

National Provider Directory

National Provider Directory

Locations

1600 Atkinson Rd
Ste 116
Lawrenceville, GA 30043
Phone (470) 294-1179

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1627257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627257600000",
    "number": "1962175083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 HERRINGTON RD APT 4301",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300442286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 HERRINGTON RD APT 4301",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300442286",
            "telephone_number": "404-863-1967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROWN EMS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-26",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A",
        "authorized_official_last_name": "CROWN",
        "authorized_official_first_name": "OVIE",
        "authorized_official_middle_name": "OSIO",
        "authorized_official_title_or_position": "MANEGER",
        "authorized_official_telephone_number": "404-863-1967",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CROWN EMS LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.

Verify at the official NPI Registry.