NPIMap

Organization Active NPI

Air Evac EMS, Inc.

  • Air Ambulance
  • Osage Beach, MO
National Provider Identifier
1073187282
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Air AmbulanceTaxonomy code 3416A0800X
Legal business name
AIR EVAC EMS, INC.
Practice address
54 Hospital Dr
Osage Beach, MO 65065-3050
Phone
(877) 288-5340
Fax
(417) 257-5761
NPI assigned
May 13, 2021
Organization subpart
Yes
Parent organization
AIR EVAC EMS, INC.As reported in NPPES

Authorized official

NPPES NPI Registry
Name
Eric Thomas
Title
Senior Vice President Rev MGMT
Phone
(877) 288-5340

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 11

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D2228054Air Evac EMS Inc Dba Ael 170/Mu 254 Hospital Drive, Osage Beach, MO 65065Certificate of waiverJun 21, 2027

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20040517001091 MO Part B Supplier - Ambulance Service Supplier 8123931755 14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Salem, MO; Poplar Bluff, MO; Sedalia, MO; Sikeston, MO; Sullivan, MO; Troy, MO; West Plains, MO; Kirksville, MO…

National Provider Directory

National Provider Directory
Tax ID family
Lifeteam Midwest Ae20 (162 organizations share this tax ID)
Part of
Lifeteam Midwest Ae20

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Air Ambulance 3416A0800X Primary

Addresses

NPPES NPI Registry

Primary practice location

54 Hospital Dr
Osage Beach, MO 65065-3050

Mailing address

PO Box 106
West Plains, MO 65775-0106
Phone (877) 288-5340

Other names 1

NPPES NPI Registry
  • Air Evac Lifeteam Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 13, 2021.

{
    "created_epoch": "1620864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620864000000",
    "number": "1073187282",
    "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": "54 HOSPITAL DR",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653050",
            "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": "2021-05-13",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT REV MGMT",
        "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 Osage Beach, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.