Organization Active NPI

Mountaineer Oxygen Services

  • Durable Medical Equipment & Medical Supplies
  • Waynesville, NC
National Provider Identifier
1417060641
Registry record updated Mar 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
02218 Issued in NC
Legal business name
MOUNTAINEER OXYGEN SERVICES
Practice address
42 Branner Ave
Waynesville, NC 28786-3292
Phone
(828) 926-0208
Fax
(828) 926-0308
NPI assigned
Aug 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2010

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

Authorized official

Name
Mr. Heath West Sutton
Title
President
Phone
(828) 926-0208

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 02218 NC Primary

Addresses

Primary practice location

42 Branner Ave
Waynesville, NC 28786-3292

Mailing address

42 Branner Ave
Waynesville, NC 28786-3292
Phone (828) 926-0208

Other identifiers 2

IdentifierTypeStateIssuer
7704440MedicaidNC
NCBDP01128OtherNCDME PERMIT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930032425 NC DME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Oxygen & Equipment 7719194059 Practice locations: Waynesville, NC

Other NPIs with the same Medicare PAC ID 1

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
Mountaineer Oxygen Services Inc42 Branner Ave, Waynesville, NC 28786-3292(828) 926-0208 Continuous Positive Airway Pressure (CPAP) Devices|Nebulizer Equipment and/or Supplies|Oxygen Equipment and/or Supplies|Respiratory Assist Devices|Ventilators Accessories and/or Supplies|Diabetic Shoes and Inserts Does not accept assignmentParticipating since Sep 29, 2003

National Provider Directory

National Provider Directory
Tax ID family
Mountaineer Oxygen Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

42 Branner Ave
Waynesville, NC 28786
Phone (828) 452-6888

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268611200000",
    "number": "1417060641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 BRANNER AVE",
            "city": "WAYNESVILLE",
            "state": "NC",
            "postal_code": "287863292",
            "telephone_number": "828-926-0208",
            "fax_number": "828-926-0308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 BRANNER AVE",
            "city": "WAYNESVILLE",
            "state": "NC",
            "postal_code": "287863292",
            "telephone_number": "828-926-0208",
            "fax_number": "828-926-0308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAINEER OXYGEN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2010-03-15",
        "status": "A",
        "authorized_official_last_name": "SUTTON",
        "authorized_official_first_name": "HEATH",
        "authorized_official_middle_name": "WEST",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "828-926-0208",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NC",
            "license": "02218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7704440",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME PERMIT",
            "identifier": "NCBDP01128",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2010; 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.