Active NPI
Crown EMS LLC
- Land Ambulance
- Lawrenceville, GA
National Provider Identifier
1962175083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240823000431 | GA | Part B Supplier - Ambulance Service Supplier | 8325587249 | Practice locations: Lawrenceville, GA |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Pharmacist
- Decatur, GA
- NPI 1629359203
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.