Burkesville Medical Supply, Inc

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

MG0187 Issued in KY

Legal business name

BURKESVILLE MEDICAL SUPPLY, INC

Practice address

365 Keen St
Burkesville, KY 42717-0006

Phone

(270) 864-2230

Fax

(270) 864-2691

NPI assigned

Aug 30, 2006

Last updated

Dec 27, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Gary Lynn White

Title

Owner Ceo

Phone

(270) 864-2230

Specialties & licenses 3

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

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

Locations

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672099200000",
    "number": "1417066424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6",
            "city": "BURKESVILLE",
            "state": "KY",
            "postal_code": "427170006",
            "telephone_number": "270-864-2230",
            "fax_number": "270-864-2691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 KEEN ST",
            "city": "BURKESVILLE",
            "state": "KY",
            "postal_code": "427170006",
            "telephone_number": "270-864-2230",
            "fax_number": "270-864-2691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURKESVILLE MEDICAL SUPPLY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER CEO",
        "authorized_official_telephone_number": "270-864-2230",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "KY",
            "license": "MG0187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100164320",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "006895400",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90040296",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ESDPT",
            "identifier": "7100165970",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ESPDT",
            "identifier": "45906005",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000070347",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Allen-Sullivan
• Dawn Rita Allen, DMD
• Whitney N Barger, DNP/APRN
• Chastity S Brown, APRN
• Cecelia Dawn Bunch, LPCC
• Capps Pharmacy Inc (Cumberland County Pharmacy)
• Capps Pharmacy Inc
• Mark Anthony Capps, RPH
• Larry David Cassady, MHE
• Natalie Frances Craft, RN

• Oxygen Equipment & Supplies (DME) in Burkesville, KY
• Providers in Burkesville, KY by specialty
• Oxygen Equipment & Supplies (DME) in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; 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.