NPIMap

Organization Active NPI

Alpine Home Medical Equipment LLC

  • Oxygen Equipment & Supplies (DME)
  • Salt Lake City, UT
National Provider Identifier
1033173646
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
License
6142158-1714 Issued in UT
Legal business name
ALPINE HOME MEDICAL EQUIPMENT LLC
Practice address
4030 S State St
Salt Lake City, UT 84107-1511
Phone
(801) 463-0044
NPI assigned
Apr 12, 2006
Last updated
May 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Authorized official

Name
Jay Broadbent
Title
Owner
Phone
(801) 590-2703

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oxygen Equipment & Supplies (DME) 332BX2000X 6142158-1714 UT Primary

Addresses

Primary practice location

4030 S State St
Salt Lake City, UT 84107-1511

Mailing address

132 E 13065 S Ste 200
Draper, UT 84020-5646
Phone (801) 463-0044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930015533 UT DME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Oxygen & Equipment 9830210863 Practice locations: Salt Lake City, UT

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Alpine Home Medical Equipment LLC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747267200000",
    "number": "1033173646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 E 13065 S STE 200",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840205646",
            "telephone_number": "801-463-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4030 S STATE ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841071511",
            "telephone_number": "801-463-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPINE HOME MEDICAL EQUIPMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-12",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A",
        "authorized_official_last_name": "BROADBENT",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-590-2703"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "UT",
            "license": "6142158-1714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.