AIR EVAC EMS, INC. (NPI# 1356980650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356980650 |
| Entity Type | Organization |
| Organization Name | AIR EVAC EMS, INC. |
| Practice Address |
125 Promenade Pkwy Fayetteville GA 30214-7712 |
| Mailing Address |
Po Box 106 West Plains MO 65775-0106 |
| Practice Telephone | 8772885340 |
| Practice Fax Number | 4172575761 |
| Mailing Telephone | 8772885340 |
| Mailing Fax Number | 4172575761 |
| Enumeration Date | 2020-01-03 |
| Last Update Date | 2020-01-03 |
| Authorized Official Name | ERIC THOMAS (SVP OF REVENUE MANAGEMENT) |
| Authorized Official Telephone | 8772885340 |
| Is Organization Subpart | Y |
| Parent Organization Name | AIR EVAC EMS, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3416A0800X |
Ambulance Specialization: Air Transport |
Transportation Services |
| Other Name | Type Code |
|---|---|
| Air Evac Lifeteam | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598398257 | Air Evac Ems, Inc. | Ambulance | 311 W 400 S, Wabash, IN 46992-7966 | 2020-02-20 |
| 1801428362 | Air Evac Ems, Inc. | Ambulance | 647 W 100 N, Portland, IN 47371-8071 | 2020-02-12 |
| 1487286423 | Air Evac Ems, Inc. | Ambulance | 1777 N 200 E, Knox, IN 46534-8162 | 2020-02-07 |
| 1265077259 | Air Evac Ems, Inc. | Ambulance | 1401 Diggs Rd Ste B, Paris, TN 38242-7538 | 2019-11-13 |
| 1861059289 | Air Evac Ems, Inc. | Ambulance | 306 Wallenburg Dr, Natchitoches, LA 71457-3680 | 2019-05-21 |
| 1114490455 | Air Evac Ems, Inc. | Ambulance | 2181 Vadalabene Dr, Maryville, IL 62062-5633 | 2019-01-09 |
| 1912472796 | Air Evac Ems, Inc. | Ambulance | 1116 Morningside Dr, Perry, GA 31069-2906 | 2018-10-09 |
| 1003394933 | Air Evac Ems, Inc. | Ambulance | 4575 Guthrie Hwy, Clarksville, TN 37040-5422 | 2018-08-02 |
| 1013400126 | Air Evac Ems, Inc. | Ambulance | 104a Industrial Dr, Waxahachie, TX 75165 | 2018-06-13 |
| 1801385661 | Air Evac Ems, Inc. | Ambulance | 18 Thomas St, Jasper, TX 75951-4975 | 2018-05-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | AIR EVAC EMS, INC. | 1001 Boardwalk Springs Place, Suite 250, O'Fallon, MO 63368 |
| Ohio Business Entities | AIR EVAC EMS, INC. | 1001 Boardwalk Spring Place, Suite 250, O'Fallon, MO 63368 |
| Colorado Business Entities | AIR EVAC EMS, INC. | 1001 Boardwalk Springs Place, Ste 250, O'fallon, MO 63368 |
| Indiana Business Entities | AIR EVAC EMS, INC. | 1001 Broadwalk Springs Place, Ste 250, O'fallon, MO 63368 |
| Oklahoma Business Registrations | AIR EVAC EMS, INC. | 1001 Boardwalk Springs Pl Ste 250, Ofallon, MO 63368 |
| Street Address |
125 PROMENADE PKWY |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30214-7712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
| 1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| Find all providers in zip 30214 | ||||
| Taxonomy Code | 3416A0800X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| Specialization | Air Transport |
| Definition to come... |
| Notes: [1/1/2005: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912472796 | Air Evac Ems, Inc. | Ambulance | 1116 Morningside Dr, Perry, GA 31069-2906 | 2018-10-09 |
| 1194247932 | Rocky Mountain Holdings, LLC | Ambulance | 459 John T Lane Rd, Thomson, GA 30824-6739 | 2017-07-13 |
| 1184162943 | Air Evac Ems, Inc. | Ambulance | 131 Britt Waters Rd Nw, Milledgeville, GA 31061-9664 | 2017-02-01 |
| 1730622838 | Air Evac Ems, Inc. | Ambulance | 304 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2016-11-22 |
| 1194061036 | Med-trans Corporation | Ambulance | 1510 Hangar Rd, Suite A, Augusta, GA 30906-9624 | 2012-12-21 |
| 1891030201 | Air Evac Ems, Inc. | Ambulance | 827 Old Bremen Rd, Carrollton, GA 30117 | 2012-12-11 |
| 1063785871 | Rocky Mountain Holdings LLC | Ambulance | 1728 Airport Dr, Ball Ground, GA 30107 | 2012-02-10 |
| 1861778052 | Rocky Mountain Holdings LLC | Ambulance | Bldg 2485, Jecelin St, Fort Benning, GA 31905 | 2011-11-01 |
| 1285919167 | Rocky Mountain Holdings LLC | Ambulance | 1775 Highland Ave, Augusta, GA 30904 | 2011-10-11 |
| 1558646430 | Rocky Mountain Holdings LLC | Ambulance | 1723 Mccollum Pkwy Nw Hngr 924, Kennesaw, GA 30144 | 2011-10-11 |
| Find all providers with the same taxonomy | ||||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.