Organization Active NPI

Total Knee Accelerated Recovery DME, LLC

  • Durable Medical Equipment & Medical Supplies
  • Southfield, MI
National Provider Identifier
1306249677
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
TOTAL KNEE ACCELERATED RECOVERY DME, LLC
Practice address
21238 Bridge St Ste B
Southfield, MI 48033-4089
Phone
(248) 550-0497
Fax
(614) 300-1420
NPI assigned
Oct 1, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Authorized official

Name
Mr. Paul Ewing
Title
Ceo
Phone
(248) 550-0497

Specialties & licenses 1

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

Addresses

Primary practice location

21238 Bridge St Ste B
Southfield, MI 48033-4089

Mailing address

21238 Bridge St Ste B
Southfield, MI 48033-4089
Phone (248) 550-0497

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150606000135 MI DME Supplier - Medical Supply Company 8921329632 Practice locations: Novi, MI

National Provider Directory

National Provider Directory

Locations

32800 Franklin Rd
Ste C
Franklin, MI 48025

40400 Grand River Ave
Ste G
Novi, MI 48375

21238 Bridge St
Ste B
Southfield, MI 48033
Phone (248) 550-0497

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1412121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635897600000",
    "number": "1306249677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21238 BRIDGE ST STE B",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480334089",
            "telephone_number": "248-550-0497",
            "fax_number": "614-300-1420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21238 BRIDGE ST STE B",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480334089",
            "telephone_number": "248-550-0497",
            "fax_number": "614-300-1420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL KNEE ACCELERATED RECOVERY DME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-01",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A",
        "authorized_official_last_name": "EWING",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "248-550-0497",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; 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.