NPIMap

Organization Active NPI

Emanuel County Commissioner of Roads & Revenues

  • Land Ambulance
  • Swainsboro, GA
National Provider Identifier
1962591966
Registry record updated Feb 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
53-01 Issued in GA
Legal business name
EMANUEL COUNTY COMMISSIONER OF ROADS & REVENUES
Practice address
117 Kite Rd
Swainsboro, GA 30401-3231
Phone
(478) 237-6809
Fax
(478) 237-4268
NPI assigned
Oct 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2013

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

Authorized official

Name
Mr. Courtney Terwilliger, EMT-P
Title
Director
Phone
(478) 237-6809

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 53-01 GA Primary

Addresses

Primary practice location

117 Kite Rd
Swainsboro, GA 30401-3231

Mailing address

117 Kite Rd
PO Box 879
Swainsboro, GA 30401-3231
Phone (478) 237-6809

Other identifiers 1

IdentifierTypeStateIssuer
000000701BMedicaidGA

Other names 1

  • EMANUEL COUNTY EMS Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040616000729 GA Part B Supplier - Ambulance Service Supplier 8426032558 Practice locations: Swainsboro, GA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360022400000",
    "number": "1962591966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 KITE RD",
            "address_2": "PO BOX 879",
            "city": "SWAINSBORO",
            "state": "GA",
            "postal_code": "304013231",
            "telephone_number": "478-237-6809",
            "fax_number": "478-237-4268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 KITE RD",
            "city": "SWAINSBORO",
            "state": "GA",
            "postal_code": "304013231",
            "telephone_number": "478-237-6809",
            "fax_number": "478-237-4268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMANUEL COUNTY COMMISSIONER OF ROADS & REVENUES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2013-02-05",
        "status": "A",
        "authorized_official_last_name": "TERWILLIGER",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "478-237-6809",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "EMT-P"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "GA",
            "license": "53-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000000701B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EMANUEL COUNTY EMS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Swainsboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2013; 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.