NPIMap

Organization Active NPI

Medway Air Ambulance LLC

  • Air Ambulance
  • Lawrenceville, GA
National Provider Identifier
1962619817
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Air AmbulanceTaxonomy code 3416A0800X
Legal business name
MEDWAY AIR AMBULANCE LLC
Practice address
570 Briscoe Blvd
Lawrenceville, GA 30046-4637
Phone
(478) 714-8838
NPI assigned
May 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Authorized official

Name
Mark Chapman
Title
Vice President Business Development
Phone
(770) 963-1412

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Air Ambulance 3416A0800X Primary

Addresses

Primary practice location

570 Briscoe Blvd
Lawrenceville, GA 30046-4637

Mailing address

PO Box 490907
Lawrenceville, GA 30049-0016
Phone (770) 963-1412

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090625000205 GA Part B Supplier - Ambulance Service Supplier 3678580750 Practice locations: Lawrenceville, GA

National Provider Directory

National Provider Directory

Locations

570 Briscoe Blvd
Lawrenceville, GA 30046
Phone (478) 714-8838

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676937600000",
    "number": "1962619817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490907",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300490016",
            "telephone_number": "770-963-1412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 BRISCOE BLVD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464637",
            "telephone_number": "478-714-8838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDWAY AIR AMBULANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2023-02-21",
        "certification_date": "2021-12-06",
        "status": "A",
        "authorized_official_last_name": "CHAPMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "VICE PRESIDENT BUSINESS DEVELOPMENT",
        "authorized_official_telephone_number": "770-963-1412"
    },
    "taxonomies": [
        {
            "code": "3416A0800X",
            "taxonomy_group": "",
            "desc": "Ambulance, Air Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 21, 2023; 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.