Active NPI
Air Evac EMS Inc
Doing business as Air Evac Lifeteam
- Air Ambulance
- Jackson, TN
National Provider Identifier
1881677995
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
- 54 Medical Center Dr
Jackson, TN 38301 - Phone
- (731) 541-5688
- Fax
- (731) 541-5643
- NPI assigned
- Nov 22, 2005
- 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
- SRVP 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
54 Medical Center Dr
Jackson, TN 38301
Mailing address
PO Box 106
West Plains, MO 65775-0106
Phone (877) 288-5340
Other names 1
- Air Evac Lifeteam
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031119000681 | TN | Part B Supplier - Ambulance Service Supplier | 8123931755 |
18 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Lafayette, TN; Waynesboro, TN; Waverly, TN; Troy, TN; Smyrna, TN; Savannah, TN; Parsons, TN; Paris, TN… |
Other NPIs on the same Medicare enrollment 18
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Air Evac Lifeteam
- Air Ambulance
- Lawrenceburg, TN
- NPI 1609131051
O20031119000681
-
dba Air Evac Lifeteam
- Air Ambulance
- Clarksville, TN
- NPI 1003394933
O20031119000681
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132617600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1537920000000",
"number": "1881677995",
"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": "54 MEDICAL CENTER DR",
"city": "JACKSON",
"state": "TN",
"postal_code": "38301",
"telephone_number": "731-541-5688",
"fax_number": "731-541-5643"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AIR EVAC EMS INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "AIR EVAC EMS INC",
"enumeration_date": "2005-11-22",
"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": "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 Jackson, TN
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.