Eaglemed LLC

Primary specialty

Air AmbulanceTaxonomy code 3416A0800X

Legal business name

EAGLEMED LLC

Practice address

1317 Lake Murray Dr S
Ardmore, OK 73401-8621

Phone

(877) 288-5340

NPI assigned

Aug 27, 2009

Organization subpart

Yes

Parent organization

EAGLEMED LLCAs reported in NPPES

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

Addresses

Other names 1

• EagleMed 17 Ardmore Other name

Part of

Eaglemed LLC

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538006400000",
    "number": "1962635722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 108",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657750108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 LAKE MURRAY DR S",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734018621",
            "telephone_number": "877-288-5340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLEMED LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAGLEMED LLC",
        "enumeration_date": "2009-08-27",
        "last_updated": "2018-09-27",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EagleMed 17 Ardmore",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "EagleMed 17 Ardmore",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Faith Dunn
• Taylor Breann Dupree, OTR/L
• Lesley Ann Dvorak
• Amy Dyer
• Mishelle Dyer, LPC
• Ears of Ardmore, Inc
• Kelsey Eastman
• Jeffrey Ebberts
• Gabbriel Echenrode
• Briyana Echols

• Air Ambulance in Ardmore, OK
• Providers in Ardmore, OK by specialty
• Air Ambulance in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; 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.