Organization Active NPI

Cumberland Medical Supply

  • Parenteral & Enteral Nutrition Supplies (DME)
  • Springfield, OH
National Provider Identifier
1366488199
Registry record updated Sep 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Parenteral & Enteral Nutrition Supplies (DME)Taxonomy code 332BP3500X
Legal business name
CUMBERLAND MEDICAL SUPPLY
Practice address
4105 S Charleston Pike
Springfield, OH 45502-9375
Phone
(937) 629-0962
Fax
(937) 629-0980
NPI assigned
Jun 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2009

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

Authorized official

Name
Mr. W. Blaine Sheffield
Title
President
Phone
(850) 654-8939

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X Primary

Addresses

Primary practice location

4105 S Charleston Pike
Springfield, OH 45502-9375

Mailing address

4383 Stonebridge Rd
Destin, FL 32541-3463
Phone (850) 654-8939

Other identifiers 6

IdentifierTypeStateIssuer
1455128MedicaidTN
3810008256MedicaidWV
R02256159MedicaidKY
101884075MedicaidPA
2052513MedicaidOH
100031700MedicaidIN

National Provider Directory

National Provider Directory

Locations

4105 S Charleston Pike
Ste A
Springfield, OH 45502
Phone (937) 629-0962

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252972800000",
    "number": "1366488199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4383 STONEBRIDGE RD",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325413463",
            "telephone_number": "850-654-8939",
            "fax_number": "850-654-8939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 S CHARLESTON PIKE",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455029375",
            "telephone_number": "937-629-0962",
            "fax_number": "937-629-0980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2009-09-15",
        "status": "A",
        "authorized_official_last_name": "SHEFFIELD",
        "authorized_official_first_name": "W.",
        "authorized_official_middle_name": "BLAINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-654-8939",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1455128",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810008256",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "R02256159",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101884075",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2052513",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100031700",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2009; 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.