NPIMap

Organization Active NPI

Provider Plus LLC

Doing business as AdaptHealth

  • Durable Medical Equipment & Medical Supplies
  • Sikeston, MO
National Provider Identifier
1376850420
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
PROVIDER PLUS LLC
Doing business as
AdaptHealth
Practice address
102 Smith Ave
Sikeston, MO 63801-5240
Phone
(573) 472-7975
Fax
(573) 472-2356
NPI assigned
Sep 10, 2010
Last updated
Sep 16, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

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

Authorized official

Name
Wendy Russalesi
Title
Cco
Phone
(484) 246-9499

Specialties & licenses 1

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

Addresses

Primary practice location

102 Smith Ave
Sikeston, MO 63801-5240

Mailing address

555 E North LN Ste 5075
Conshohocken, PA 19428-2490

Other identifiers 1

IdentifierTypeStateIssuer
1376850420MedicaidMO

Other names 1

  • AdaptHealth Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110309000860 MO DME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Oxygen & EquipmentDME Supplier - Medical Supply Company 5991822140 Practice locations: Sikeston, MO

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Provider Plus Inc102 Smith Avenue, Sikeston, MO 63801-5240(573) 472-7975 Commodes, Urinals, Bedpans|Continuous Passive Motion (CPM) Devices|Contracture Treatment Devices: Dynamic Splint|Blood Glucose Monitors/Supplies (Non-Mail Order)|Gastric Suction Pumps|Heat & Cold Applications|Hospital Beds (Electric)|Hospital Beds (Manual)|Infrared Heating Pads Systems and/or Suppl… Does not accept assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Provider Plus LLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

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

Locations

4634 N Illinois St
Fairview Heights, IL 62208
Phone (618) 222-8800

4932 Benchmark Centre Dr
Ste 34
Swansea, IL 62226
Phone (618) 222-8800

13208 W 99th St
Lenexa, KS 66215
Phone (913) 492-4548

170 Industrial Dr
Ste 106
Crystal Cty, MO 63028
Phone (636) 931-9440

102 Smith Ave
Sikeston, MO 63801
Phone (573) 472-7975

NPI Registry JSON

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

{
    "created_epoch": "1284076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789516800000",
    "number": "1376850420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 E NORTH LN STE 5075",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194282490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 SMITH AVE",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015240",
            "telephone_number": "573-472-7975",
            "fax_number": "573-472-2356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDER PLUS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-10",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A",
        "authorized_official_last_name": "RUSSALESI",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "CCO",
        "authorized_official_telephone_number": "484-246-9499"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376850420",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AdaptHealth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sikeston, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; 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.