Medostomy

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

MEDOSTOMY

Practice address

1465 Oregon Dr
Sacramento, CA 95822-2655

Phone

(916) 690-9463

NPI assigned

Jul 31, 2019

Last updated

Jul 31, 2019By 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

Louis S Verhoeven Sr.NPI 1144874751

Title

Owner/ President

Phone

(916) 690-9463

Specialties & licenses 1

Addresses

Electronic endpoints 1

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.

• Louis S Verhoeven Sr.

  • Customized Equipment (DME)
  • Sacramento, CA
  • NPI 1144874751
  NPD Authorized official

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564531200000",
    "number": "1255985867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 OREGON DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958222655",
            "telephone_number": "916-690-9463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 OREGON DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958222655",
            "telephone_number": "916-690-9463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDOSTOMY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-31",
        "last_updated": "2019-07-31",
        "status": "A",
        "authorized_official_last_name": "VERHOEVEN",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/ PRESIDENT",
        "authorized_official_telephone_number": "916-690-9463",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "CA",
            "affiliation": "N",
            "address_1": "1465 Oregon Dr",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "958222655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Whitney Louise Medlicott
• Alix Nicole Medlin, MSW
• Medmark Treatment Centers - Sacramento, Inc.
• Medmark Treatment Services
• Christy Marie Mednick
• Carolina Medrano
• Deidre Medrano
• Kimberly Medrano
• Kristinna Medrano
• Prescilla Medrano

• Customized Equipment (DME) in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Customized Equipment (DME) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2019; 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.