Air Evac EMS, Inc.
Organization Active NPI Air Ambulance · Clarksville, TN
NPI 1003394933 · NPPES record last updated Jan 10, 2025
Key facts
- NPI
- 1003394933
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Air Ambulance 3416A0800X
- Legal business name
- AIR EVAC EMS, INC.
- Practice address
- 209 Hampton Ridge Dr
Clarksville, TN 37040-7642 - Phone
- (877) 288-5340
- Fax
- (417) 257-5761
- NPI assigned
- Aug 2, 2018
- Organization subpart
- Yes
- Parent organization (as reported)
- AIR EVAC EMS, INC.
Authorized official
- Name
- Eric Thomas
- Title
- Senior Vice President, Revenue MGMT
- Phone
- (877) 288-5340
Other NPIs on the same Medicare enrollment 18
Corporate family (same tax ID) 12
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D2163628 | Air Evac Lifeteam Ael | Certificate of waiver | Mar 18, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031119000681 | TN | Part B Supplier - Ambulance Service Supplier | 8123931755 |
18 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Lafayette, TN; Waynesboro, TN; Waverly, TN; Troy, TN; Smyrna, TN; Savannah, TN; Parsons, TN; Paris, TN… |
National Provider Directory
- Tax ID family
- Lifeteam Midwest Ae20
- Part of
- Lifeteam Midwest Ae20
Locations
4575 Guthrie Hwy
Clarksville, TN 37040
Phone (931) 645-7675
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Air Ambulance | 3416A0800X | Yes |
Addresses
Primary practice location
209 Hampton Ridge Dr
Clarksville, TN 37040-7642
Mailing address
PO Box 106
West Plains, MO 65775-0106
Phone (877) 288-5340
Other names
- Air Evac Lifeteam
Other providers in Clarksville, TN
- Amanda Aguirre
- Maqbool Ahmed
- Adrienne Aikin
- Donatus Ailodion
- Aim Comprehensive Therapy LLC
- Olaide Ifelola Ajayi
- Tamer Akoury
- Mujtaba Alamiri
- Matthew Richard Aldred
- Blaire Alexander
All providers in Clarksville, TN · Air Ambulance in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.