Pikeville Medical Equipment & Supplies, Inc.

Key facts

NPI: 1366491177
Entity type: Organization (NPI type 2)
Primary specialty: Durable Medical Equipment & Medical Supplies 332B00000X
License: NOT REQUIRED IN KY (KY)
Legal business name: PIKEVILLE MEDICAL EQUIPMENT & SUPPLIES, INC.
Practice address: 789A N Mayo TR
Pikeville, KY 41501-1686
Phone: (606) 432-6011
Fax: (606) 432-6085
NPI assigned: May 9, 2006
Organization subpart: No

Authorized official

Name: Mrs. Shelia Goodman Watson
Title: Ceo
Phone: (606) 432-6011

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Supplier	Supplies	Medicare assignment
Pikeville Medical Equipment & Suppl 789A N Mayo TRL, Pikeville, KY 41501-3472 · (606) 432-6011	Commodes, Urinals, Bedpans\|Continuous Passive Motion (CPM) Devices\|Hospital Beds (Electric)\|Hospital Beds (Manual)\|Osteogenesis Stimulators\|Pneumatic Compression Devices and/or Supplies\|Support Surfaces: Pressure Reducing Beds/Mats/Pads\|Canes and/or Crutches\|Walkers\|Wheelchairs (Standard Manual)\|Wh…	Does not accept assignment Participating since Jan 1, 2011

Medicare participation

Medicare fee-for-service enrollment: Enrolled in KY

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20100930096314	KY	DME Supplier - Medical Supply Company DME Supplier - Oxygen & Equipment	2961618715	Practice locations: Pikeville, KY

National Provider Directory

Locations

789 N Mayo Trl
#A
Pikeville, KY 41501
Phone (606) 432-6011

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Durable Medical Equipment & Medical Supplies	332B00000X	NOT REQUIRED IN KY	KY	Yes

Addresses

Primary practice location

789A N Mayo TR
Pikeville, KY 41501-1686

Mailing address

PO Box 3816
Pikeville, KY 41502-3816
Phone (606) 432-6011

Other identifiers

Identifier	Type	State	Issuer
000000320773	Other	KY	ANTHEM
90007188	Medicaid	KY

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 28, 2016.

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469664000000",
    "number": "1366491177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3816",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415023816",
            "telephone_number": "606-432-6011",
            "fax_number": "606-432-6085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789A N MAYO TR",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415011686",
            "telephone_number": "606-432-6011",
            "fax_number": "606-432-6085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIKEVILLE MEDICAL EQUIPMENT & SUPPLIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2016-07-28",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "SHELIA",
        "authorized_official_middle_name": "GOODMAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "606-432-6011",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "KY",
            "license": "NOT REQUIRED IN KY",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000320773",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90007188",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pikeville, KY

All providers in Pikeville, KY · Durable Medical Equipment & Medical Supplies in Kentucky

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2016. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (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.