PUCKETT EMERGENCY MEDICAL SERVICES, LLC (NPI# 1699769158) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699769158 |
| Entity Type | Organization |
| Organization Name | PUCKETT EMERGENCY MEDICAL SERVICES, LLC |
| Other Organization Name | PUCKETT EMERGENCY MEDICAL SERVICES, INC |
| Practice Address |
3760 Tramore Point Pkwy Austell GA 30106 |
| Mailing Address |
3760 Tramore Point Parkway Austell GA 30106 |
| Practice Telephone | 7702225045 |
| Practice Fax Number | 7709435150 |
| Mailing Telephone | 7702225045 |
| Mailing Fax Number | 7709435150 |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | MR. ROBERT A JEWELL (VP - REVENUE CYCLE MANAGEMENT) |
| Authorized Official Telephone | 8445974911 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 341600000X | Ambulance | 03343 | GA | Transportation Services |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000902107A | 05 |
| Other Name | Type Code |
|---|---|
| PUCKETT EMERGENCY MEDICAL SERVICES | Doing Business As Name - Organization |
| PUCKETT EMERGENCY MEDICAL SERVICES, INC | Former Legal Business Name - Organization |
| PUCKETT EMS | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720300379 | Puckett Emergency Medical Services, LLC | Ambulance | 5603 Ringgold Rd, East Ridge, TN 37412-3131 | 2010-02-24 |
| Street Address |
3760 TRAMORE POINT PKWY |
| City | AUSTELL |
| State | GA |
| Zip Code | 30106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073126231 | Courtney Lashune Dorsett | Nurse Practitioner | 1005 Cureton Drive, Austell, Austell, GA 30106 | 2020-08-27 |
| 1184240491 | Brian H Eves | Dietitian, Registered | 3972 Brantley Drive, Austell, GA 30106 | 2020-06-23 |
| 1669014486 | Jesse Mccoy | Registered Nurse | 3950 Austell Rd., Austell, GA 30106 | 2019-10-14 |
| 1427522820 | Envision Optics LLC | Optometrist | 1680 E West Connector, Austell, GA 30106 | 2019-01-18 |
| 1972042380 | Thomas Dental Group | Clinic/Center | 1133 East West Connector, Suite 120, Austell, GA 30106 | 2017-02-17 |
| 1245779792 | Colton Dental Group | Clinic/Center | 2495 East-west Connector, Ste 60, Austell, GA 30106 | 2017-02-16 |
| 1144691684 | Georgia Dental Professionals, PC | Dentist | 780 East West Connector Sw, Suite 108, Austell, GA 30106 | 2015-10-09 |
| 1285013714 | Ikeade Bello Alamu | Nurse Practitioner | 2870 Betula Drive, Austell, GA 30106 | 2015-05-29 |
| 1376922211 | Jessica Williams | Obstetrics & Gynecology | 1700 Hospital South Dr Ste 500, Austell, GA 30106 | 2015-05-26 |
| 1558799593 | Tonya Renee Baldwin | Speech-Language Pathologist | 4229 Brass Trl., Austell, GA 30106 | 2013-10-30 |
| Find all providers in zip 30106 | ||||
| Taxonomy Code | 341600000X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| An emergency vehicle used for transporting patients to a health care facility after injury or illness. Types of ambulances used in the United States include ground (surface) ambulance, rotor-wing (helicopter), and fixed-wing aircraft (airplane). |
| Notes: Source: Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 37. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225546096 | Amazing Grace Ems Corporation | Ambulance | 2889 Line St, Austell, GA 30106-3902 | 2018-01-16 |
| 1124448766 | Caring Hands Ems | Ambulance | 2891 Line St, Austell, GA 30106-3902 | 2014-04-22 |
| 1841257599 | Elite Ems, LLC | Ambulance | 4760 Austell Rd, Suite 6, Austell, GA 30106-2007 | 2006-04-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245854280 | Conquest Medical Transport, LLC | Ambulance | 182 Riley Ave Ste F1, Macon, GA 31204-0777 | 2020-06-05 |
| 1184268393 | Atlanta Ems Lllp | Ambulance | 2555 Marietta Hwy Ste 205b, Canton, GA 30114-7054 | 2019-10-30 |
| 1295376838 | Luke Medical Transport LLC | Ambulance | 260 International Pkwy Ste 132, Dallas, GA 30157-5706 | 2019-10-04 |
| 1619521366 | Sure Care Ems | Ambulance | 2136 W Park Ct Bldg 2, Stone Mountain, GA 30087-3528 | 2019-07-31 |
| 1184278848 | Person To Person Transportation Service L.l.c | Ambulance | 6724 Church St Ste 3, Riverdale, GA 30274-4711 | 2019-07-30 |
| 1609428176 | Tykechia Todd | Ambulance | 3644 Caseys Cove, Ellenwood, GA 30294 | 2019-07-15 |
| 1699337717 | Priscilla Mark-wilson | Ambulance | 3350 Noor Way, Douglasville, GA 30135-8172 | 2019-06-29 |
| 1285194829 | Regional Ambulance Service, LLC | Ambulance | 2054 Rex Rd Ste 5c, Morrow, GA 30260-3970 | 2019-03-20 |
| 1790243814 | Randy Scott Crocker | Ambulance | 5615 Handley Blvd, Morrow, GA 30260-3919 | 2019-03-07 |
| 1114491438 | 1st Responders 2 Ems | Ambulance | 155 Westridge Pkwy Ste 113, Mcdonough, GA 30253-3050 | 2019-01-21 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.