Doc Supply of West Tennessee, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

1014 Issued in TN

Legal business name

DOC SUPPLY OF WEST TENNESSEE, LLC

Practice address

2192 Express Drive
Suite C
Jackson, TN 38305

Phone

(800) 306-5160

Fax

(800) 481-1206

NPI assigned

Feb 3, 2010

Last updated

Oct 8, 2021By 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

Mr. Robert Thomas Baldridge, ATP

Title

Owner

Phone

(800) 306-5160

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Home Medical Products, Inc

  • Oxygen Equipment & Supplies (DME)
  • Columbia, TN
  • NPI 1619527249

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1265155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633651200000",
    "number": "1265764088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2192 EXPRESS DRIVE",
            "address_2": "SUITE C",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38305",
            "telephone_number": "800-306-5160",
            "fax_number": "800-481-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2192 EXPRESS DRIVE",
            "address_2": "SUITE C",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38305",
            "telephone_number": "800-306-5160",
            "fax_number": "800-481-1206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOC SUPPLY OF WEST TENNESSEE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-03",
        "last_updated": "2021-10-08",
        "certification_date": "2021-09-24",
        "status": "A",
        "authorized_official_last_name": "BALDRIDGE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "800-306-5160",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ATP"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TN",
            "license": "1014",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "TN",
            "license": "1014",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura L Dipuma, MD
• Felicia Tawah Che Ditah
• Linda Dixon, RDH
• Martha Dixon, RD, LDN
• DLP Medical LLC (Lisa Piercey, MD)
• Pamela Doering
• Michael G Doherty, MD
• Heather R Dolan, A.P.R.N.
• Michael Sean Dolan, MD
• Heather Doles

• Durable Medical Equipment & Medical Supplies in Jackson, TN
• Providers in Jackson, TN by specialty
• Durable Medical Equipment & Medical Supplies in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2021; 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.