Organization Active NPI

Drayer Medical Equipment

  • Durable Medical Equipment & Medical Supplies
  • Lafayette, IN
National Provider Identifier
1518162155
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
DRAYER MEDICAL EQUIPMENT
Practice address
2228-B Sagamore Pkwy S
Lafayette, IN 47905-5112
Phone
(765) 607-6858
Fax
(765) 807-0090
NPI assigned
Jun 15, 2007
Last updated
Mar 4, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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

Authorized official

Name
Barton Todd Drayer
Title
Owner
Phone
(765) 607-6858

Specialties & licenses 1

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

Addresses

Primary practice location

2228-B Sagamore Pkwy S
Lafayette, IN 47905-5112

Mailing address

2228-B Sagamore Pkwy S
Lafayette, IN 47905-5112
Phone (765) 607-6858

Other identifiers 1

IdentifierTypeStateIssuer
200877980AMedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930058318 IN DME Supplier - Medical Supply Company 5092910034 Practice locations: Lafayette, IN

National Provider Directory

National Provider Directory

Locations

210 Professional Ct
Lafayette, IN 47905
Phone (765) 447-3443

2228B Sagamore Pkwy S
Lafayette, IN 47905
Phone (765) 607-6858

NPI Registry JSON

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583280000000",
    "number": "1518162155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2228-B SAGAMORE PKWY S",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055112",
            "telephone_number": "765-607-6858",
            "fax_number": "765-807-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2228-B SAGAMORE PKWY S",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055112",
            "telephone_number": "765-607-6858",
            "fax_number": "765-807-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRAYER MEDICAL EQUIPMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-15",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A",
        "authorized_official_last_name": "DRAYER",
        "authorized_official_first_name": "BARTON",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-607-6858"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200877980A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; 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.