EAST TEXAS FLIGHT AMBULANCE (NPI# 1770663056) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770663056 |
| Entity Type | Organization |
| Organization Name | EAST TEXAS FLIGHT AMBULANCE |
| Other Organization Name | AIR ONE EAST TEXAS MEDICAL CENTER |
| Practice Address |
1000 S Beckham Ave Tyler TX 75701-1908 |
| Mailing Address |
Po Box 6838 Tyler TX 75711-6838 |
| Practice Telephone | 9035318285 |
| Practice Fax Number | 9035963298 |
| Mailing Telephone | 9035318285 |
| Mailing Fax Number | 9035963298 |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2015-03-27 |
| Authorized Official Name | MRS. TERRI K. ROWDEN (DIRECTOR AIR ONE) |
| Authorized Official Telephone | 9035318285 |
| Authorized Official Credential | RN, BSN |
| Is Organization Subpart | Y |
| Parent Organization Name | EAST TEXAS MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3416A0800X |
Ambulance Specialization: Air Transport |
212022 | TX | Transportation Services |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | TRICARE | 751803325 | 01 |
| TX | BC/BS | AMB014 | 01 |
| TX | 020812602 | 05 | |
| TX | PREFERRED CARE | 152677FY | 01 |
| Other Name | Type Code |
|---|---|
| Air One East Texas Medical Center | Doing Business As Name - Organization |
| Street Address |
1000 S BECKHAM AVE |
| City | TYLER |
| State | TX |
| Zip Code | 75701-1908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740280510 | Aleksandra Olsson-detwiler | Internal Medicine | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2005-07-22 |
| 1831706431 | Kalana Sanders | Registered Nurse | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2020-09-28 |
| 1992333975 | Graceanne M. Dimon | Physical Therapist | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2020-03-27 |
| 1760021976 | Gerardo Tapia Hernandez | Nurse Practitioner | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2020-01-06 |
| 1861950057 | Brittany Mason Ferguson | Nurse Practitioner | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2019-03-06 |
| 1255801189 | Shane Ashley Correa | Nurse Practitioner | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2018-12-04 |
| 1174000962 | David Matthew Burkland | Nurse Practitioner | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2018-07-24 |
| 1598251209 | Kelsey Rene Morton | Nurse Practitioner | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2018-07-05 |
| 1063915916 | Tyler Regional Hospital LLC | Surgery | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2018-03-16 |
| 1437650264 | Tyler Regional Hospital LLC | Nurse Anesthetist, Certified Registered | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2018-02-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
| 1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
| 1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
| 1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
| 1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
| 1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
| 1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
| 1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
| Find all providers in zip 75701 | ||||
| Taxonomy Code | 3416A0800X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| Specialization | Air Transport |
| Definition to come... |
| Notes: [1/1/2005: title modified] |
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|---|---|---|---|---|
| 1861004079 | American International Transport LLC | Ambulance | 721 Dallas Ave., Mcallen, TX 78501 | 2020-08-19 |
| 1225663297 | Rocky Mountain Holdings, LLC | Ambulance | 1815 Airport Loop, Kerrville, TX 78028-9696 | 2020-03-10 |
| 1558923177 | Med-trans Corporation | Ambulance | 8926 Hangar Rd, San Angelo, TX 76904-4071 | 2019-07-03 |
| 1316507510 | 24-7 Air Evac, Inc. | Ambulance | 550 Reserve St Ste 190, Southlake, TX 76092-1575 | 2019-06-19 |
| 1013400126 | Air Evac Ems, Inc. | Ambulance | 104a Industrial Dr, Waxahachie, TX 75165 | 2018-06-13 |
| 1104319599 | Airmed Response LLC | Ambulance | 10440 John Cape Rd Ste 206, San Antonio, TX 78216-4101 | 2018-06-11 |
| 1801385661 | Air Evac Ems, Inc. | Ambulance | 18 Thomas St, Jasper, TX 75951-4975 | 2018-05-08 |
| 1104349901 | Med-trans Corporation | Ambulance | 209 State Highway 121 Byp Ste 11, Lewisville, TX 75067-4203 | 2017-07-24 |
| 1245772722 | Air Evac Ems, Inc. | Ambulance | 675 Deshong Dr, Paris, TX 75460-9315 | 2016-11-15 |
| 1669922985 | Med-trans Corporation | Ambulance | 10201 Airport Blvd Bldg 4, Amarillo, TX 79111-1227 | 2016-10-11 |
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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.