NPIMap

Organization Active NPI

Gaddy Enterprises, Inc

  • Durable Medical Equipment & Medical Supplies
  • Nacogdoches, TX
National Provider Identifier
1447776331
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
GADDY ENTERPRISES, INC
Practice address
3500 North St Ste 1a
Nacogdoches, TX 75965-2485
Phone
(936) 569-8585
Fax
(936) 569-8525
NPI assigned
Aug 22, 2017
Organization subpart
Yes
Parent organization
GADDY ENTERPRISES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Authorized official

Name
Mrs. Amanda BushNPI 1952721664
Title
President
Phone
(936) 590-4464

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

3500 North St Ste 1a
Nacogdoches, TX 75965-2485

Mailing address

PO Box 1035
Center, TX 75935-1035
Phone (936) 590-4464

Other names 1

  • GADDY'S MEDICAL EQUIPMENT & SUPPLIES Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220623001167 TX DME Supplier - Medical Supply CompanyDME Supplier - Oxygen & Equipment 2567573785 Practice locations: Nacogdoches, TX

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Part of
Gaddy Enterprises Inc

Locations

300 Hurst St
Center, TX 75935
Phone (936) 590-4464

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1503360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698105600000",
    "number": "1447776331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1035",
            "city": "CENTER",
            "state": "TX",
            "postal_code": "759351035",
            "telephone_number": "936-590-4464",
            "fax_number": "936-590-4468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 NORTH ST STE 1A",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759652485",
            "telephone_number": "936-569-8585",
            "fax_number": "936-569-8525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GADDY ENTERPRISES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GADDY ENTERPRISES, INC",
        "enumeration_date": "2017-08-22",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A",
        "authorized_official_last_name": "BUSH",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "936-590-4464",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GADDY'S MEDICAL EQUIPMENT & SUPPLIES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nacogdoches, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.