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NPI 1356761589 · Knoxville, TN · Land Ambulance
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Shoals Ambulance LLC is a land ambulance provider located in Knoxville, Tennessee. This profile covers 7 Medicare and 11 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Shoals Ambulance LLC |
| Address | 910 Callahan Dr |
| City | Knoxville |
| State | TN |
| ZIP | 37912 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | April 28, 2014 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $17.4M |
| Medicare | $11.1M |
SHOALS AMBULANCE LLC’s billing profile is consistent with a high-volume ground ambulance operator: the top Medicare and Medicaid revenue-driving codes are ambulance transport and mileage codes (A0427, A0425, A0428/A0429), indicating primary business activity is emergency and non-emergency ground transports rather than clinic- or procedure-based care. The prominence of advanced life support emergency transport (A0427) across both payers signals frequent high-acuity emergency responses.
Revenue concentration is high for both payers: the precomputed top-three Medicare codes account for 89.8% of the provider’s total Medicare revenue, and the precomputed top-three Medicaid codes account for 86.5% of total Medicaid revenue, showing that a very small set of transport-related services drive the overwhelming share of receipts. This concentration suggests limited service-line diversification beyond core ambulance transports and mileage.
Payer mix shows Medicaid receipts exceed Medicare for this provider: total Medicaid revenue is $17.4M compared with total Medicare revenue of $11.1M, indicating the provider generates more lifetime revenue from state Medicaid programs than from Medicare. The business therefore serves a substantial Medicaid population and should be evaluated with Medicaid program dynamics in mind.
On Medicare-specific competitive standing, SHOALS reports exceptionally large volumes for key ambulance codes: A0425 (ground mileage) ranks #7 nationally and is labeled an “extreme outlier,” A0427 ranks #35 nationally as an “extreme outlier,” and A0428 ranks #27 as an “extreme outlier.” These rankings place the provider among the very highest-volume national suppliers for those codes, consistent with being a major national outlier in Medicare ambulance billing.
On the Medicaid side, the provider is also a dominant in-state performer for the same core services: A0427 ranks #5 in-state (97th percentile, notably above typical state volume) and A0428 ranks #2 in-state (99th percentile, extreme outlier). The provider additionally ranks #1 in-state for A0426 (advanced life support non-emergency) with a 100th percentile ranking described as an extreme outlier, supporting the view that SHOALS is a leading ambulance supplier within Tennessee Medicaid.
Code-level statistical standing reinforces operational emphasis on ALS and mileage: several codes are explicitly called out as “extreme outlier” or “notably above typical” in the supplied data (e.g., Medicare A0425 and A0427; Medicaid A0428 and A0426), meaning the provider’s volumes for those services are far above typical peers rather than within normal variation. These labels suggest SHOALS’ activity levels for transport and mileage are unusual relative to the peer sets.
Operational tenure is established but not long-tenured compared with many institutional providers: the NPI was enumerated on 2014-04-28 (~12 years ago), indicating over a decade of presence in Medicare/Medicaid billing; this tenure is sufficient to have established substantial cumulative revenue and market position in-state and nationally for ambulance services.
Service mix nuance: while ALS emergency (A0427) and mileage (A0425) dominate revenue for both payers, the provider also bills material volumes of BLS non-emergency (A0428) and BLS emergency (A0429), implying a blended operation handling both emergent and scheduled/non-emergent transports rather than exclusively 911 response. That mix can reflect contracts for non-emergency patient transfers, interfacility moves, and routine transport in addition to emergency response.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 10,530 | $370 | $3.9M |
| A0425 | Ground mileage, per statute mile | 455,820 | $10 | $3.6M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 13,270 | $190 | $2.5M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 2,470 | $310 | $766.3K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 930 | $240 | $219.2K |
| A0433 | Advanced life support, level 2 (als 2) | 210 | $530 | $111K |
| A0434 | Specialty care transport (sct) | 70 | $630 | $42.8K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
11 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 70,280 | $120 | $8.6M |
| A0425 | Ground mileage, per statute mile | 183,330 | $20 | $3.7M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 22,550 | $120 | $2.8M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 87,510 | $20 | $1.8M |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 6,740 | $50 | $316.8K |
| A0433 | Advanced life support, level 2 (als 2) | 980 | $150 | $144.5K |
| A0434 | Specialty care transport (sct) | 180 | $130 | $22.1K |
| A0382 | Bls routine disposable supplies | 3,620 | $1 | $14.5K |
| A0380 | Bls mileage (per mile) | 1,180 | $10 | $5.9K |
| A0398 | Als routine disposable supplies | 40 | $1 | $70 |
Showing 1–10 of 11
How this provider's Medicaid billing volume and revenue compare to other Tennessee providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Tennessee median
11 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 5 | 120 | 5,200 | $120 | $1.4M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 6 | 110 | 2,170 | $110 | $650.5K |
| A0425 | Ground mileage, per statute mile | 7 | 340 | 6,120 | $10 | $280.5K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 2 | 120 | 3,840 | $20 | $207.3K |
| A0434 | Specialty care transport (sct) | 4 | 10 | 180 | $250 | $117.6K |
| A0433 | Advanced life support, level 2 (als 2) | 5 | 20 | 220 | $170 | $104.7K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 1 | 70 | 160 | $20 | $14K |
| A0380 | Bls mileage (per mile) | 6 | 50 | 250 | $10 | $7.1K |
| A0398 | Als routine disposable supplies | 10 | 10 | 1,520 | $1 | $4.4K |
| A0382 | Bls routine disposable supplies | 2 | 10 | 400 | $1 | $3.3K |
Showing 1–10 of 11
Other providers in the same ZIP code as Shoals Ambulance LLC, ranked by combined Medicare and Medicaid revenue.
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