Eaglemed LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

EAGLEMED LLC

Practice address

6601 W Pueblo Dr
Wichita, KS 67209-2926

Phone

(877) 288-5340

NPI assigned

Sep 22, 2009

Organization subpart

Yes

Parent organization

EAGLEMED LLCAs reported in NPPES

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

Addresses

Other names 1

• Wichita Ground Other name

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

CLIA laboratory certificates

Part of

Eaglemed LLC

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

{
    "created_epoch": "1253577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538006400000",
    "number": "1285968313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 108",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657750108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 W PUEBLO DR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672092926",
            "telephone_number": "877-288-5340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLEMED LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAGLEMED LLC",
        "enumeration_date": "2009-09-22",
        "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": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wichita Ground",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Wichita Ground",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• All providers in Wichita, KS
• Land Ambulance in Kansas

• 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 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.