NPIMap

Organization Active NPI

Air Evac EMS, Inc.

  • Air Ambulance
  • Grove, OK
National Provider Identifier
1760061618
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Air AmbulanceTaxonomy code 3416A0800X
Legal business name
AIR EVAC EMS, INC.
Practice address
872 E 11TH St
Grove, OK 74344-2965
Phone
(877) 288-5340
Fax
(417) 257-5761
NPI assigned
Apr 7, 2021
Organization subpart
Yes
Parent organization
AIR EVAC EMS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 10, 2023

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

Authorized official

Name
Eric Thomas
Title
Senior Vice President Revenue Cycle
Phone
(877) 288-5340

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Air Ambulance 3416A0800X Primary

Addresses

Primary practice location

872 E 11TH St
Grove, OK 74344-2965

Mailing address

PO Box 106
West Plains, MO 65775-0106
Phone (877) 288-5340

Other names 1

  • Air Evac Lifeteam Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040730001084 OK Part B Supplier - Ambulance Service Supplier 8123931755 19 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Woodward, OK; Weatherford, OK; Seminole, OK; Ponca City, OK; Pauls Valley, OK; Muskogee, OK; Kingfisher, OK; Idabel, OK…

Other NPIs on the same Medicare enrollment 19

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

View all 19

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
37D2231115Air Evac Lifeteam 165872 E 11TH Street, Grove, OK 74344Certificate of waiverJul 29, 2027

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 16

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

View all 16

Locations

335 Airport Dr
Grove, OK 74344

NPI Registry JSON

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675987200000",
    "number": "1760061618",
    "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",
            "telephone_number": "877-288-5340",
            "fax_number": "417-257-5761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "872 E 11TH ST",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "743442965",
            "telephone_number": "877-288-5340",
            "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": "2021-04-07",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-03",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT REVENUE CYCLE",
        "authorized_official_telephone_number": "877-288-5340"
    },
    "taxonomies": [
        {
            "code": "3416A0800X",
            "taxonomy_group": "",
            "desc": "Ambulance, Air Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Grove, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2023; 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.