Organization Active NPI

Direct Medical, Incorporated

  • Durable Medical Equipment & Medical Supplies
  • Belleville, IL
National Provider Identifier
1073776225
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
DIRECT MEDICAL, INCORPORATED
Practice address
335 W Main St
Belleville, IL 62220-1505
Phone
(866) 710-7679
NPI assigned
Jul 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Authorized official

Name
Joel Michael Futerer
Title
Director Operations
Phone
(310) 293-5197

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

335 W Main St
Belleville, IL 62220-1505

Mailing address

335 W Main St
Belleville, IL 62220-1505
Phone (866) 710-7679

Other identifiers 2

IdentifierTypeStateIssuer
1077376225MedicaidMO
1073776225MedicaidIL

National Provider Directory

National Provider Directory

Locations

121 S Illinois St
Belleville, IL 62220
Phone (619) 277-7250

2801 W Main St
Belleville, IL 62226
Phone (618) 234-3053

335 W Main St
Belleville, IL 62220
Phone (866) 710-7679

NPI Registry JSON

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689206400000",
    "number": "1073776225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 W MAIN ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201505",
            "telephone_number": "866-710-7679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 W MAIN ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201505",
            "telephone_number": "866-710-7679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIRECT MEDICAL, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-08",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A",
        "authorized_official_last_name": "FUTERER",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "DIRECTOR OPERATIONS",
        "authorized_official_telephone_number": "310-293-5197"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1077376225",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073776225",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2023; 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.