Jackson County B O C

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

078-02 Issued in GA

Legal business name

JACKSON COUNTY B O C

Doing business as

Jackson County Emergency Services

Practice address

86 Gordon St
Jefferson, GA 30549-1528

Phone

(833) 810-5005

Fax

(888) 965-4620

NPI assigned

Jan 15, 2007

Last updated

Dec 26, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jason Baker

Title

EMS Director

Phone

(706) 367-6356

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Jackson County Emergency Services Doing business as

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": "1168819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514246400000",
    "number": "1982755138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936418",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311936418",
            "telephone_number": "833-810-5005",
            "fax_number": "888-965-4620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 GORDON ST",
            "city": "JEFFERSON",
            "state": "GA",
            "postal_code": "305491528",
            "telephone_number": "833-810-5005",
            "fax_number": "888-965-4620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON COUNTY B O C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-15",
        "last_updated": "2017-12-26",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "EMS DIRECTOR",
        "authorized_official_telephone_number": "706-367-6356"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "GA",
            "license": "078-02",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590603182",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "NH540",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000055976A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "191662",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson County Emergency Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Georgia Cameron Hutchins, APRN,BC
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• Dana Buck Irwin, N.P.
• Jackson County Health Department (Jackson Co BD of HLTH)
• Jackson County Health Department
• Jackson County Health Department
• Jackson County School System
• Jackson County Senior Center

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2017; 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.