JERRON GEDDIS NPI 1073938528

NPI Information

NPI: 1073938528
Provider Name: JERRON GEDDIS
Classification: Non-emergency Medical Transport (VAN) - 343900000X
Entity Type: Individual
Address:
5421 S MAY ST
CHICAGO, IL
ZIP 60609
Phone: (773) 354-5421
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Jerron Geddis is a non emergency medical transport van in Chicago, IL. The provider is a land vehicle with a capacity to meet special height, clearance, access, and seating, for the conveyance of persons in non-emergency situations. The vehicle may or may not be required to meet local county or state regulations. Jerron Geddis NPI is 1073938528. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5421 S MAY ST
CHICAGO, IL
ZIP 60609-052
Phone: (773) 354-5421

The enumeration date for this NPI number is 2/20/2014 and was last updated on 2/20/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	License Number	License State	Primary
1	343800000X	Secured Medical Transport (VAN)	G32042068362	ILLINOIS	No
2	347C00000X	Private Vehicle	G32042068362	ILLINOIS	No
3	347E00000X	Transportation Broker	G32042068362	ILLINOIS	No
4	343900000X	Non-emergency Medical Transport (VAN)	G32042068362	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	46-4868691	MEDICAID	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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