Active NPI
Mountaineer Oxygen Services
- Durable Medical Equipment & Medical Supplies
- Waynesville, NC
National Provider Identifier
1417060641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 02218
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7704440 | Medicaid | NC | |
| NCBDP01128 | Other | NC | DME PERMIT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930032425 | NC | DME Supplier - Medical Supply Company With Respiratory Therapist | 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 NPIMapThese 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
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Mountaineer Oxygen Services Inc | 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 assignment |
National Provider Directory
National Provider Directory- Tax ID family
- Mountaineer Oxygen Services
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Oxygen Equipment & Supplies (DME)
- Sylva, NC
- NPI 1902003999
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.