Medic One, LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

069132 Issued in MO

Legal business name

MEDIC ONE, LLC

Doing business as

Medic One Ambulance

Practice address

6007 Dalton Farmer Dr
Jonesboro, AR 72404-8895

Phone

(870) 972-0708

NPI assigned

Nov 3, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kim Mann

Title

President

Phone

(870) 972-8484

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• MEDIC ONE AMBULANCE Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Medic One, LLC

  dba Medic One Ambulance Service

  • Land Ambulance
  • Jonesboro, AR
  • NPI 1336114131

  3779511852

  Same PAC ID

Tax ID family

Medic One LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Medic One, LLC

  dba Medic One Ambulance Service

  • Land Ambulance
  • Jonesboro, AR
  • NPI 1336114131
  NPD tax ID

Locations

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713139200000",
    "number": "1114006939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6007 DALTON FARMER DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724048895",
            "telephone_number": "870-931-8566",
            "fax_number": "870-972-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6007 DALTON FARMER DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724048895",
            "telephone_number": "870-972-0708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIC ONE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-972-8484"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MO",
            "license": "069132",
            "primary": true
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806255303",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDIC ONE AMBULANCE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MEDIC ONE AMBULANCE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bridget Means
• Lynda Means, CIS
• Madison Mears
• Med-Trans Corporation
• Medic 1 Air, LLC (Medic 1 Air)
• Medic One, LLC (Medic One Ambulance Service)
• Medical Mobility Equipment
• Medical Necessities
• Medical Necessities of Arkansas, LLC
• Medical Necessities, Inc

• Land Ambulance in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Land Ambulance in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; 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.