Total Medical Supply, LLC

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

06136 11.1 Issued in MS

Legal business name

TOTAL MEDICAL SUPPLY, LLC

Practice address

558 1St South St
Woodville, MS 39669-3777

Phone

(601) 888-3373

Fax

(601) 888-4767

NPI assigned

Dec 11, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Gary Russell Johnson, PTNPI 1285794107

Title

Owner

Phone

(601) 888-3373

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 3

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

• Gary Russell Johnson, PT

  • Physical Therapist
  • Woodville, MS
  • NPI 1285794107
  NPD (past) Authorized official
• Virginia Lewis, D.P.T.

  • Physical Therapist
  • Woodville, MS
  • NPI 1659650802
  NPD (past)
• Lori K Taylor, OT

  • Specialist
  • Woodville, MS
  • NPI 1255429924
  NPD (past)

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306906375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12617 WARWICK AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708156847",
            "telephone_number": "225-275-6415",
            "fax_number": "225-275-6415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "558 1ST SOUTH ST",
            "city": "WOODVILLE",
            "state": "MS",
            "postal_code": "396693777",
            "telephone_number": "601-888-3373",
            "fax_number": "601-888-4767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL MEDICAL SUPPLY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-888-3373",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "MS",
            "license": "06136 11.1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04700561",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pradeep Kumar Selvaraj, M.D
• Megan Sistrunk
• Roslyn Jill Smith, PHARMD
• Lori K Taylor, OT
• Lashonda Tolliver
• Woodville Dental Care LLC
• Woodville Home Health Services, Inc.
• Jonnecia Wyatt, FNP-C

• Oxygen Equipment & Supplies (DME) in Woodville, MS
• Providers in Woodville, MS by specialty
• Oxygen Equipment & Supplies (DME) in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.