NPIMap

Organization Active NPI

Air Evac EMS Inc.

Doing business as Air Evac Lifeteam

  • Air Ambulance
  • West Plains, MO
National Provider Identifier
1689658932
Registry record updated Sep 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Air AmbulanceTaxonomy code 3416A0800X
Legal business name
AIR EVAC EMS INC.
Doing business as
Air Evac Lifeteam
Practice address
1802 Air Medical Dr
West Plains, MO 65775
Phone
(417) 257-2613
Fax
(417) 257-5761
NPI assigned
Nov 30, 2005
Last updated
Sep 26, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
AIR EVAC EMS INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 26, 2018

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

Authorized official

Name
Eric Thomas
Title
SRVP of Revenue Management
Phone
(877) 288-5340

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Air Ambulance 3416A0800X Primary

Addresses

Primary practice location

1802 Air Medical Dr
West Plains, MO 65775

Mailing address

PO Box 106
West Plains, MO 65775-0106

Other identifiers 1

IdentifierTypeStateIssuer
AEL-001 WEST PLAINSOtherBASE ID

Other names 1

  • Air Evac Lifeteam Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040517001091 MO Part B Supplier - Ambulance Service Supplier 8123931755 14 other NPIs on this enrollment
Practice locations: Salem, MO; Poplar Bluff, MO; Sedalia, MO; Sikeston, MO; Sullivan, MO; Troy, MO; West Plains, MO; Kirksville, MO…

Other NPIs with the same Medicare PAC ID 14

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

View all 14

Other NPIs on the same Medicare enrollment 14

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

View all 14

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D1087749Air Evac EMS Inc Dba Air Evac 1 West Plains1802 Air Medical Drive, West Plains, MO 65775Certificate of waiverAug 10, 2026

National Provider Directory

National Provider Directory
Tax ID family
Lifeteam Midwest Ae20162 organizations share this tax ID, including this one
Part of
Lifeteam Midwest Ae20

Organizations with this tax ID in the same state 11

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

Locations

1802 Air Medical Dr
West Plains, MO 65775
Phone (417) 257-2613

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537920000000",
    "number": "1689658932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 106",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657750106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 AIR MEDICAL DR",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "65775",
            "telephone_number": "417-257-2613",
            "fax_number": "417-257-5761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AIR EVAC EMS INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AIR EVAC EMS INC.",
        "enumeration_date": "2005-11-30",
        "last_updated": "2018-09-26",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "SRVP 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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BASE ID",
            "identifier": "AEL-001 WEST PLAINS",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Air Evac Lifeteam",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Air Evac Lifeteam",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Plains, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.