CCC Medical Equipment, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

878 Issued in TN

Legal business name

CCC MEDICAL EQUIPMENT, INC.

Practice address

115 Vicksburg Ave
Camden, TN 38320-1613

Phone

(731) 584-7919

Fax

(731) 584-7920

NPI assigned

Jun 5, 2006

Last updated

Feb 9, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Roy L Dedmon II

Title

Owner

Phone

(731) 584-7919

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518134400000",
    "number": "1013956077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 VICKSBURG AVENUE",
            "city": "CAMDEN",
            "state": "TN",
            "postal_code": "383201636",
            "telephone_number": "731-584-7919",
            "fax_number": "731-584-7920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 VICKSBURG AVE",
            "city": "CAMDEN",
            "state": "TN",
            "postal_code": "383201613",
            "telephone_number": "731-584-7919",
            "fax_number": "731-584-7920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCC MEDICAL EQUIPMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-05",
        "last_updated": "2018-02-09",
        "status": "A",
        "authorized_official_last_name": "DEDMON",
        "authorized_official_first_name": "ROY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "731-584-7919",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TN",
            "license": "878",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TN",
            "license": "00878",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1455003",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Camden Operator LLC (Camden Healthcare & Rehab Center)
• Steven Lee Cannady, F.N.P.
• William Raymond Carney, M.D.
• Matthew Carrico, PA-C
• Mickie Carter, MS, PA-C
• CCC Medical Equipment, Inc.
• Shawn Fortenberry Churchill Coy, FNP-BC, PMHNP-BC
• Carlton Lynn Cole
• Christina Cole
• Core Men's Health

• Durable Medical Equipment & Medical Supplies in Camden, TN
• Providers in Camden, TN by specialty
• Durable Medical Equipment & Medical Supplies in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.