NPIMap

Organization Active NPI

Med-Trans Corporation

  • Air Ambulance
  • Jacksboro, TN
National Provider Identifier
1083868517
Registry record updated Sep 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Air AmbulanceTaxonomy code 3416A0800X
Legal business name
MED-TRANS CORPORATION
Practice address
588 Memorial Lane
Jacksboro, TN 37757-0000
Phone
(877) 288-5340
NPI assigned
Nov 11, 2008
Last updated
Sep 27, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
MED-TRANS CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 27, 2018

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)CodeLicenseStatePrimary
Air Ambulance 3416A0800X Primary

Addresses

Primary practice location

588 Memorial Lane
Jacksboro, TN 37757-0000

Mailing address

PO Box 708
West Plains, MO 65775-0708
Phone (877) 288-5340

Other names 1

  • UT LIFESTAR 4 Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070824000217 TN Part B Supplier - Ambulance Service Supplier 8921904145 15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rockwood, TN; Winchester, TN; Sweetwater, TN; Sparta, TN; Sevierville, TN; Nashville, TN; Memphis, TN; MC Kenzie, TN…

Other NPIs on the same Medicare enrollment 15

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

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Med-Trans Corporation Wings117 organizations share this tax ID, including this one
Part of
Med-Trans Corporation Wings

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

588 Memorial Ln
Jacksboro, TN 37757
Phone (423) 437-8851

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1226361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538006400000",
    "number": "1083868517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 708",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657750708",
            "telephone_number": "877-288-5340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "588 MEMORIAL LANE",
            "city": "JACKSBORO",
            "state": "TN",
            "postal_code": "377570000",
            "telephone_number": "877-288-5340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED-TRANS CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MED-TRANS CORPORATION",
        "enumeration_date": "2008-11-11",
        "last_updated": "2018-09-27",
        "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": "UT LIFESTAR 4",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "UT LIFESTAR 4",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jacksboro, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; 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.

Verify at the official NPI Registry.