Diversified Security Group

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

DIVERSIFIED SECURITY GROUP

Practice address

836 E Main St Ste 6
Medford, OR 97504-7115

Phone

(541) 779-5611

Fax

(541) 779-6355

NPI assigned

Sep 27, 2006

Organization subpart

No

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

Authorized official

Name

Matthew Robert Duncan

Title

Owner

Phone

(541) 779-5611

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114018975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 E MAIN ST STE 6",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047115",
            "telephone_number": "541-779-5611",
            "fax_number": "541-779-6355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 E MAIN ST STE 6",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047115",
            "telephone_number": "541-779-5611",
            "fax_number": "541-779-6355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSIFIED SECURITY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DUNCAN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-779-5611"
    },
    "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": "028095",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dimitrios J. Vareldzis DDS PC
• Devin Dimond, DPM
• Heidi Annette Dirkse-Graw, LPC
• Marc Ditommaso, RPH
• Erin Marie Dittmer, NP
• Elizabeth Divine, DNP
• Robert Neill Divine, BA
• Alanna R Dixon, PA-C
• Bren Dixon, D.M.D.
• Damon Dixon

• Durable Medical Equipment & Medical Supplies in Medford, OR
• Providers in Medford, OR by specialty
• Durable Medical Equipment & Medical Supplies in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.