NPIMap

Organization Active NPI

Appalachian Medical LLC.

  • Durable Medical Equipment & Medical Supplies
  • Beckley, WV
National Provider Identifier
1144949041
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
APPALACHIAN MEDICAL LLC.
Practice address
1802 Harper Rd Ste 100
Beckley, WV 25801-3376
Phone
(304) 345-8501
NPI assigned
Aug 24, 2022
Last updated
Jun 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Authorized official

Name
Mary Arietta Wiseman
Title
Member Manager
Phone
(304) 345-8501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

1802 Harper Rd Ste 100
Beckley, WV 25801-3376

Mailing address

4702 Maccorkle Ave SW
South Charleston, WV 25309-1330
Phone (304) 541-0988

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230511000298 WV DME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Oxygen & Equipment 5991052565 Practice locations: Beckley, WV

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Appalachian Medical LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1802 Harper Rd
Ste 100
Beckley, WV 25801
Phone (304) 345-8501

NPI Registry JSON

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719446400000",
    "number": "1144949041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4702 MACCORKLE AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091330",
            "telephone_number": "304-541-0988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 HARPER RD STE 100",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013376",
            "telephone_number": "304-345-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPALACHIAN MEDICAL LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-24",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "WISEMAN",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ARIETTA",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "304-345-8501"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beckley, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.