Maverick Oxygen & Respiratory Equipment, LLC

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

MG0450 Issued in KY

Legal business name

MAVERICK OXYGEN & RESPIRATORY EQUIPMENT, LLC

Practice address

2510 Allen LN
La Grange, KY 40031-8580

Phone

(502) 225-4772

Fax

(502) 225-0605

NPI assigned

Nov 10, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Scott Kittleson

Title

President/Owner

Phone

(502) 225-4772

Specialties & licenses 1

Addresses

Other names 1

• Maverick Group, LLC Former legal business name

Locations

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

{
    "created_epoch": "1226275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226275200000",
    "number": "1609020221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 ALLEN LN",
            "city": "LA GRANGE",
            "state": "KY",
            "postal_code": "400318580",
            "telephone_number": "502-225-4772",
            "fax_number": "502-225-0605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 ALLEN LN",
            "city": "LA GRANGE",
            "state": "KY",
            "postal_code": "400318580",
            "telephone_number": "502-225-4772",
            "fax_number": "502-225-0605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAVERICK OXYGEN & RESPIRATORY EQUIPMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-10",
        "last_updated": "2008-11-10",
        "status": "A",
        "authorized_official_last_name": "KITTLESON",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "502-225-4772",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "KY",
            "license": "MG0450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maverick Group, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Nancy Marshall, DPT
• Ashley Sierra Martin
• Tonya Leann Martin, APRN, FNP-C
• Mary K. Sargis
• Patrick M Matthiessen, MD
• Ahrissa Monique McCarthy, BSN, RN
• Dawn Rae McClure
• Mary Kathryn McClure
• Angela Morrison McCurdy, PTA
• Darrick Matthew McDanald, M.D.

• All providers in La Grange, KY
• Oxygen Equipment & Supplies (DME) in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2008; 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.