JK Medical Supplies LLC

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

JK MEDICAL SUPPLIES LLC

Practice address

6569 Edsall Rd
Springfield, VA 22151-4414

Phone

(571) 222-5829

Fax

(571) 351-6081

NPI assigned

Nov 25, 2024

Last updated

Nov 25, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jamal KhattakNPI 1457188518

Title

Owner

Phone

(571) 222-5829

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Jamal Ud Din Khattak

  • Oxygen Equipment & Supplies (DME)
  • Springfield, VA
  • NPI 1457188518
  NPD Authorized official

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

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732492800000",
    "number": "1215753330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6569 EDSALL RD",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221514414",
            "telephone_number": "571-222-5829",
            "fax_number": "571-351-6081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6569 EDSALL RD",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221514414",
            "telephone_number": "571-222-5829",
            "fax_number": "571-351-6081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JK MEDICAL SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-25",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-24",
        "status": "A",
        "authorized_official_last_name": "KHATTAK",
        "authorized_official_first_name": "JAMAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "571-222-5829"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oxygen Equipment & Supplies (DME) in Springfield, VA
• Providers in Springfield, VA by specialty
• Oxygen Equipment & Supplies (DME) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.