Active NPI
Air Evac EMS, Inc.
Doing business as Air Evac Lifeteam
- Air Ambulance
- Idabel, OK
National Provider Identifier
1871962472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Air Ambulance
- Legal business name
- AIR EVAC EMS, INC.
- Doing business as
- Air Evac Lifeteam
- Practice address
- 1200 SE Avenue N
Idabel, OK 74745-7834 - Phone
- (877) 288-5340
- Fax
- (417) 257-5761
- NPI assigned
- Sep 24, 2015
- Last updated
- Sep 26, 2018
- Organization subpart
- Yes
- Parent organization
- AIR EVAC EMS, INC.
NPPES NPI Registry
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
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Air Ambulance | 3416A0800X | NU | Primary |
Addresses
Primary practice location
1200 SE Avenue N
Idabel, OK 74745-7834
Mailing address
PO Box 106
West Plains, MO 65775-0106
Other names 1
- Air Evac Lifeteam
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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.
-
dba Air Evac Lifeteam
- Air Ambulance
- Pauls Valley, OK
- NPI 1225739055
O20040730001084
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 37D2102428 | Air Evac Lifeteam Air Evac #129 | Certificate of waiver | Sep 21, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Air Evac EMS
- Part of
- Air Evac EMS
Organizations with this tax ID in the same state 14
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
Locations
1200 SE Avenue N
Idabel, OK 74745
Phone (580) 286-5290
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443052800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1537920000000",
"number": "1871962472",
"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": "1200 SE AVENUE N",
"city": "IDABEL",
"state": "OK",
"postal_code": "747457834",
"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": "2015-09-24",
"last_updated": "2018-09-26",
"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": "3416A0800X",
"taxonomy_group": "",
"desc": "Ambulance, Air Transport",
"state": "NU",
"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 Idabel, OK
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.