NPIMap

Organization Active NPI

Gallup Med Flight, LLC

  • Air Ambulance
  • Gallup, NM
National Provider Identifier
1154435238
Registry record updated Aug 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Air AmbulanceTaxonomy code 3416A0800X
License
06-00000788 Issued in NM
Legal business name
GALLUP MED FLIGHT, LLC
Practice address
2111 W Historic Highway 66
Gallup, NM 87301
Phone
(801) 619-4900
Fax
(801) 619-8077
NPI assigned
Aug 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2018

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

Authorized official

Name
Mr. Eric Thomas
Title
SVP of Revenue Management
Phone
(877) 288-5340

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Air Ambulance 3416A0800X 06-00000788 NM Primary
Land Ambulance 3416L0300X

Addresses

Primary practice location

2111 W Historic Highway 66
Gallup, NM 87301

Mailing address

10888 S 300 W
South Jordan, UT 84095-4043
Phone (801) 619-4900

Other identifiers 8

IdentifierTypeStateIssuer
06023803MedicaidMI
XMTA05996MedicaidCA
RB48OtherNMBC'BS OF NM PROVIDER #
0551606MedicaidIA
800185OtherFEDERAL BLACK LUNG PROGRA
804824MedicaidAZ
G1735MedicaidNM
93272839MedicaidCO

Other names 1

  • Gallup Med Flight Doing business as

National Provider Directory

National Provider Directory

Locations

2111 W Highway 66
Ste 6
Gallup, NM 87301

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533254400000",
    "number": "1154435238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10888 S 300 W",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840954043",
            "telephone_number": "801-619-4900",
            "fax_number": "801-619-8077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 W HISTORIC HIGHWAY 66",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "87301",
            "telephone_number": "801-619-4900",
            "fax_number": "801-619-8077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALLUP MED FLIGHT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2018-08-03",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416A0800X",
            "taxonomy_group": "",
            "desc": "Ambulance, Air Transport",
            "state": "NM",
            "license": "06-00000788",
            "primary": true
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06023803",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XMTA05996",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC'BS OF NM PROVIDER #",
            "identifier": "RB48",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0551606",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG PROGRA",
            "identifier": "800185",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "804824",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G1735",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "93272839",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gallup Med Flight",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gallup Med Flight",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gallup, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.