NPIMap

Organization Active NPI

Madison County Medical Equipment Inc

Doing business as Jackson Medical Supply

  • Oxygen Equipment & Supplies (DME)
  • Boone, IA
National Provider Identifier
1588639983
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
License
5864 Issued in IA
Legal business name
MADISON COUNTY MEDICAL EQUIPMENT INC
Doing business as
Jackson Medical Supply
Practice address
1504 S Marshall St
Boone, IA 50036-5311
Phone
(515) 432-0960
Fax
(515) 432-0954
NPI assigned
Feb 20, 2006
Last updated
Oct 14, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
AEROCARE HOLDINGS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Authorized official

Name
Wendy Russalesi
Title
Cco
Phone
(484) 246-9499

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X
Oxygen Equipment & Supplies (DME) 332BX2000X 5864 IA Primary

Addresses

Primary practice location

1504 S Marshall St
Boone, IA 50036-5311

Mailing address

555 E North LN Ste 5075
Conshohocken, PA 19428-2490

Other identifiers 3

IdentifierTypeStateIssuer
22151OtherIAWELLMARK BCBS
0216432MedicaidIA
61271OtherIACOVENTRY HEALTHCARE

Other names 1

  • JACKSON MEDICAL SUPPLY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930003278 IA DME Supplier - Medical Supply CompanyDME Supplier - Oxygen & Equipment 5395866685 Practice locations: Boone, IA

Other NPIs with the same Medicare PAC ID 11

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

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Jackson Medical Supply1504 S Marshall St, Boone, IA 50036-5311(515) 432-0960 Commodes, Urinals, Bedpans|Continuous Passive Motion (CPM) Devices|Hospital Beds (Electric)|Hospital Beds (Manual)|External Infusion Pumps and/or Supplies|Insulin Infusion Pumps and/or Supplies|Negative Pressure Wound Therapy Pumps/Supplies|Support Surfaces: Pressure Reducing Beds/Mats/Pads|Canes a… Does not accept assignmentParticipating since Nov 30, 1999

National Provider Directory

National Provider Directory
Tax ID family
Madison County Medical Equipment Inc12 organizations share this tax ID, including this one
Part of
Aerocare Holdings Inc

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1020 Story St
Boone, IA 50036

NPI Registry JSON

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760400000000",
    "number": "1588639983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 E NORTH LN STE 5075",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194282490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 S MARSHALL ST",
            "city": "BOONE",
            "state": "IA",
            "postal_code": "500365311",
            "telephone_number": "515-432-0960",
            "fax_number": "515-432-0954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON COUNTY MEDICAL EQUIPMENT INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AEROCARE HOLDINGS, INC.",
        "enumeration_date": "2006-02-20",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A",
        "authorized_official_last_name": "RUSSALESI",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "CCO",
        "authorized_official_telephone_number": "484-246-9499"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "IA",
            "license": "5864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "22151",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0216432",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY HEALTHCARE",
            "identifier": "61271",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JACKSON MEDICAL SUPPLY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "JACKSON MEDICAL SUPPLY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boone, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; 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.