Incontrol Medical, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

INCONTROL MEDICAL, LLC

Practice address

3225 Gateway Rd
Suite 250
Brookfield, WI 53045-5134

Phone

(262) 373-0422

NPI assigned

May 22, 2012

Organization subpart

No

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

Authorized official

Name

Herschel Peddicord

Title

President/Ceo

Phone

(262) 373-0422

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1337644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337644800000",
    "number": "1487914644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 GATEWAY RD",
            "address_2": "SUITE 250",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530455134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 GATEWAY RD",
            "address_2": "SUITE 250",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530455134",
            "telephone_number": "262-373-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INCONTROL MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-22",
        "last_updated": "2012-05-22",
        "status": "A",
        "authorized_official_last_name": "PEDDICORD",
        "authorized_official_first_name": "HERSCHEL",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "262-373-0422"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.