Active NPI
Direct Medical, Incorporated
- Durable Medical Equipment & Medical Supplies
- Belleville, IL
National Provider Identifier
1073776225
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1077376225 | Medicaid | MO | |
| 1073776225 | Medicaid | IL |
National Provider Directory
National Provider DirectoryLocations
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.