NPIMap

Organization Active NPI

Alpine Home Medical Equipment LLC

  • Oxygen Equipment & Supplies (DME)
  • Idaho Falls, ID
National Provider Identifier
1194154930
Registry record updated Jul 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
Legal business name
ALPINE HOME MEDICAL EQUIPMENT LLC
Practice address
2425 Channing Way
Idaho Falls, ID 83404-8059
Phone
(208) 535-8627
Fax
(208) 529-3368
NPI assigned
Nov 2, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2016

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

Authorized official

Name
Jay Broadbent
Title
Owner
Phone
(801) 590-2703

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oxygen Equipment & Supplies (DME) 332BX2000X Primary

Addresses

Primary practice location

2425 Channing Way
Idaho Falls, ID 83404-8059

Mailing address

132 E 13065 S Ste 200
Draper, UT 84020-5646
Phone (801) 590-2780

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140228001294 ID DME Supplier - Medical Supply CompanyDME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Oxygen & Equipment 9830210863 Practice locations: Idaho Falls, ID

Other NPIs with the same Medicare PAC ID 10

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Alpine Home Medical Equipment LLC2425 Channing Way, Idaho Falls, ID 83404-8059(208) 535-8627 Hospital Beds (Electric)|Support Surfaces: Pressure Reducing Beds/Mats/Pads|Patient Lifts|Power Operated Vehicles (Scooters)|Walkers|Wheelchairs (Standard Manual)|Wheelchairs (Standard Manual Related Accessories)|Wheelchairs (Standard Power)|Wheelchairs (Standard Power Related Accessories)|Wheelcha… Does not accept assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Alpine Home Medical Equipment LLC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467331200000",
    "number": "1194154930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 E 13065 S STE 200",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840205646",
            "telephone_number": "801-590-2780",
            "fax_number": "801-590-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048059",
            "telephone_number": "208-535-8627",
            "fax_number": "208-529-3368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPINE HOME MEDICAL EQUIPMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-02",
        "last_updated": "2016-07-01",
        "status": "A",
        "authorized_official_last_name": "BROADBENT",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-590-2703"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.