Active NPI
Air Evac EMS, Inc.
Doing business as Air Evac Lifeteam
- Air Ambulance
- Clarinda, IA
National Provider Identifier
1073104691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Air Ambulance
- Legal business name
- AIR EVAC EMS, INC.
- Doing business as
- Air Evac Lifeteam
- Practice address
- 323 W Laperla Dr
Clarinda, IA 51632-3004 - Phone
- (877) 288-5340
- Fax
- (417) 257-5761
- NPI assigned
- Jan 27, 2021
- Organization subpart
- Yes
- Parent organization
- AIR EVAC EMS, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Eric Thomas
- Title
- SVP of Revenue Management
- Phone
- (877) 288-5340
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Air Ambulance | 3416A0800X | Primary |
Addresses
Primary practice location
323 W Laperla Dr
Clarinda, IA 51632-3004
Mailing address
PO Box 106
West Plains, MO 65775-0106
Phone (877) 288-5340
Other names 1
- Air Evac Lifeteam
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050816001048 | IA | Part B Supplier - Ambulance Service Supplier | 8123931755 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Keokuk, IA |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Part of
- Lifeteam Midwest Ae20
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611705600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1611705600000",
"number": "1073104691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 106",
"city": "WEST PLAINS",
"state": "MO",
"postal_code": "657750106",
"telephone_number": "877-288-5340",
"fax_number": "417-257-5761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "323 W LAPERLA DR",
"city": "CLARINDA",
"state": "IA",
"postal_code": "516323004",
"telephone_number": "877-288-5340",
"fax_number": "417-257-5761"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AIR EVAC EMS, INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "AIR EVAC EMS, INC.",
"enumeration_date": "2021-01-27",
"last_updated": "2021-01-27",
"certification_date": "2021-01-27",
"status": "A",
"authorized_official_last_name": "THOMAS",
"authorized_official_first_name": "ERIC",
"authorized_official_title_or_position": "SVP OF REVENUE MANAGEMENT",
"authorized_official_telephone_number": "877-288-5340"
},
"taxonomies": [
{
"code": "3416A0800X",
"taxonomy_group": "",
"desc": "Ambulance, Air Transport",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Air Evac Lifeteam",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Clarinda, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; 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.