Memphis Medical Center Air Ambulance Service, Inc.

Primary specialty

Air AmbulanceTaxonomy code 3416A0800X

License

EMS0000009906 Issued in TN

Legal business name

MEMPHIS MEDICAL CENTER AIR AMBULANCE SERVICE, INC.

Practice address

1080 Eastmoreland Ave
Memphis, TN 38104-3327

Phone

(901) 522-5321

NPI assigned

Sep 16, 2006

Organization subpart

No

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

Authorized official

Name

Mr. John A. Butora Jr.

Title

Ceo

Phone

(901) 522-5321

Specialties & licenses 1

Addresses

Other identifiers 11

Other names 1

• Hospital Wing Doing business as

Locations

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422316800000",
    "number": "1336245463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 205149",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753205149",
            "telephone_number": "901-522-5321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 EASTMORELAND AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043327",
            "telephone_number": "901-522-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMPHIS MEDICAL CENTER AIR AMBULANCE SERVICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2015-01-27",
        "status": "A",
        "authorized_official_last_name": "BUTORA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "901-522-5321",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "3416A0800X",
            "taxonomy_group": "",
            "desc": "Ambulance, Air Transport",
            "state": "TN",
            "license": "EMS0000009906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3574476",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "4043897",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5500075600",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160813501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENNCARE SELECT",
            "identifier": "4043897",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148123715",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805962206",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00553958",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENNCARE BETTER HEALTH",
            "identifier": "132775",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TLC",
            "identifier": "22924",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENNCARE OMNICARE/DORAL",
            "identifier": "55982",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hospital Wing",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Air Ambulance in Memphis, TN
• Providers in Memphis, TN by specialty
• Air Ambulance in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2015; 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.