Phoenix Medical Supply Specialists, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PHOENIX MEDICAL SUPPLY SPECIALISTS, LLC

Doing business as

Phoenix Medical Supply

Practice address

7950 E Mississippi Ave Ste D
Denver, CO 80247-2151

Phone

(303) 747-7189

Fax

(303) 955-2397

NPI assigned

May 6, 2020

Organization subpart

No

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

Authorized official

Name

Leonid Reznikov

Title

General Partner

Phone

(720) 436-7613

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Phoenix Medical Supply Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CO

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

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

{
    "created_epoch": "1588723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688601600000",
    "number": "1487275012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7950 E MISSISSIPPI AVE STE D",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802472151",
            "telephone_number": "303-747-7189",
            "fax_number": "303-955-2397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7950 E MISSISSIPPI AVE STE D",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802472151",
            "telephone_number": "303-747-7189",
            "fax_number": "303-955-2397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX MEDICAL SUPPLY SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-06",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A",
        "authorized_official_last_name": "REZNIKOV",
        "authorized_official_first_name": "LEONID",
        "authorized_official_title_or_position": "GENERAL PARTNER",
        "authorized_official_telephone_number": "720-436-7613"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO STATE",
            "identifier": "20201346609",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info2@phoenixmedicalsupply.us",
            "affiliation": "N",
            "address_1": "7950 E Mississippi Ave Ste D",
            "city": "Denver",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802472151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Phoenix Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alexander C. Philpott, M.D.
• Osgoode S Philpott, M.D.
• Peter J Philpott, M.D.
• Maggie Phipps, MS, CCC-SLP
• Phoenix Medical Supply
• Phoenix Mental Health & Wellness, PLLC
• Phoenix Orthotics and Prosthetics LLC
• Phoenix Therapy LLC
• Sonemala Phommatha, PA-C
• Phonda Hackett, PSYD

• Durable Medical Equipment & Medical Supplies in Denver, CO
• Providers in Denver, CO by specialty
• Durable Medical Equipment & Medical Supplies in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; 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.