NPIMap

Organization Active NPI

Sandusky Wellness DME LLC

  • Durable Medical Equipment & Medical Supplies
  • Sandusky, OH
National Provider Identifier
1134534225
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SANDUSKY WELLNESS DME LLC
Practice address
3703 Columbus Ave.
Sandusky, OH 44870-5719
Phone
(419) 625-8085
Fax
(419) 625-6004
NPI assigned
Jun 26, 2014
Last updated
Aug 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Authorized official

Name
Dr. Susan J Graham, M.D.NPI 1427274976
Title
Operating Manager
Phone
(419) 625-8085

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
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

3703 Columbus Ave.
Sandusky, OH 44870-5719

Mailing address

3703 Columbus Ave
Sandusky, OH 44870-5719
Phone (419) 625-8085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141031002039 OH DME Supplier - Physician - Unknown Physician Specialty 4486875648 Practice locations: Sandusky, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723680000000",
    "number": "1134534225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3703 COLUMBUS AVE",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448705719",
            "telephone_number": "419-625-8085",
            "fax_number": "419-625-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3703 COLUMBUS AVE.",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448705719",
            "telephone_number": "419-625-8085",
            "fax_number": "419-625-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDUSKY WELLNESS DME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-26",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OPERATING MANAGER",
        "authorized_official_telephone_number": "419-625-8085",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.