Orthosource, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ORTHOSOURCE, INC.

Doing business as

Kimlor Medical Supply

Practice address

1675 W Jefferson St Ste E
Siloam Springs, AR 72761-3001

Phone

(479) 373-2510

Fax

(479) 373-2509

NPI assigned

Jan 5, 2022

Organization subpart

Yes

Parent organization

ORTHOSOURCE INC.As reported in NPPES

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

Authorized official

Name

James Hal Dejarnatt

Title

Owner

Phone

(479) 373-2510

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kimlor Medical Supply Doing business as

Part of

Orthosource Inc

Locations

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.

• Orthosource, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Springdale, AR
  • NPI 1831112614
  NPPES parent name

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

{
    "created_epoch": "1641340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649980800000",
    "number": "1578224218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7510",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727667510",
            "telephone_number": "479-872-1885",
            "fax_number": "479-872-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 W JEFFERSON ST STE E",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727613001",
            "telephone_number": "479-373-2510",
            "fax_number": "479-373-2509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOSOURCE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ORTHOSOURCE INC.",
        "enumeration_date": "2022-01-05",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A",
        "authorized_official_last_name": "DEJARNATT",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "HAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-373-2510"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "161293716",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kimlor Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Siloam Springs, AR
• Providers in Siloam Springs, AR by specialty
• Durable Medical Equipment & Medical Supplies in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2022; 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.