Organization Active NPI

Special Needs Solutions, LLC

  • Customized Equipment (DME)
  • Tyler, TX
National Provider Identifier
1124199369
Registry record updated Aug 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
Legal business name
SPECIAL NEEDS SOLUTIONS, LLC
Practice address
13213 Hwy 155 S
Suite B
Tyler, TX 75703-6561
Phone
(903) 330-0821
NPI assigned
Nov 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2011

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

Authorized official

Name
Ray Bockover, ATPNPI 1871889048
Title
Manager
Phone
(903) 330-0821

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X Primary

Addresses

Primary practice location

13213 Hwy 155 S
Suite B
Tyler, TX 75703-6561

Mailing address

13213 Hwy 155 S
Suite B
Tyler, TX 75703-6561
Phone (903) 330-0821

Other identifiers 7

IdentifierTypeStateIssuer
162607601MedicaidTX
162618602MedicaidTX
162618603MedicaidTX
162618606MedicaidTX
162618604MedicaidTX
531822OtherTXBLUECROSS BLUESHIELD
162618605MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Special Needs Solutions LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

13213 Highway 155 S
Ste B
Tyler, TX 75703
Phone (903) 330-0821

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314057600000",
    "number": "1124199369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13213 HWY 155 S",
            "address_2": "SUITE B",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757036561",
            "telephone_number": "903-330-0821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13213 HWY 155 S",
            "address_2": "SUITE B",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757036561",
            "telephone_number": "903-330-0821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIAL NEEDS SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-10",
        "last_updated": "2011-08-23",
        "status": "A",
        "authorized_official_last_name": "BOCKOVER",
        "authorized_official_first_name": "RAY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "903-330-0821",
        "authorized_official_credential": "ATP"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162607601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162618602",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162618603",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162618606",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162618604",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "531822",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162618605",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2011; 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.