NPIMap

Organization Active NPI

Lifebrite Hospital Group of Early LLC

  • Ambulance
  • Blakely, GA
National Provider Identifier
1992238430
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
Legal business name
LIFEBRITE HOSPITAL GROUP OF EARLY LLC
Practice address
12155 Columbia St
Blakely, GA 39823-2536
Phone
(229) 724-4136
NPI assigned
Apr 11, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Authorized official

Name
Morgan Dunn
Title
Ceo
Phone
(601) 849-6440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X GA Primary

Addresses

Primary practice location

12155 Columbia St
Blakely, GA 39823-2536

Mailing address

11740 Columbia St
Blakely, GA 39823-2574

Other names 1

  • Early EMS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201119001165 GA Part B Supplier - Ambulance Service Supplier 7810263589 Practice locations: Blakely, GA

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Lifebrite Hosp GRP of Early6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3 S Jefferson Ave
Blakely, GA 39823

Practitioners & affiliated clinicians

Practitioners 12

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": "1491868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692748800000",
    "number": "1992238430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11740 COLUMBIA ST",
            "city": "BLAKELY",
            "state": "GA",
            "postal_code": "398232574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12155 COLUMBIA ST",
            "city": "BLAKELY",
            "state": "GA",
            "postal_code": "398232536",
            "telephone_number": "229-724-4136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRITE HOSPITAL GROUP OF EARLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-11",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A",
        "authorized_official_last_name": "DUNN",
        "authorized_official_first_name": "MORGAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-849-6440"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Early EMS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Early EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blakely, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.