Medsource LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

16-00299 Issued in KS

Legal business name

MEDSOURCE LLC

Practice address

8600 W 95TH St
Suite 100a
Overland Park, KS 66212

Phone

(913) 499-0481

Fax

(913) 499-0482

NPI assigned

Mar 2, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Eric Rohde

Title

Owner

Phone

(309) 664-7930

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1267488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534550400000",
    "number": "1134442361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1248",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617021248",
            "telephone_number": "309-664-7930",
            "fax_number": "309-664-7931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 W 95TH ST",
            "address_2": "SUITE 100A",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "66212",
            "telephone_number": "913-499-0481",
            "fax_number": "913-499-0482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSOURCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-02",
        "last_updated": "2018-08-18",
        "status": "A",
        "authorized_official_last_name": "ROHDE",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-664-7930",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "KS",
            "license": "16-00299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "16-00391",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Durable Medical Equipment & Medical Supplies in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2018; 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.