Organization Active NPI

Alpine Medical Supply LLC

  • Durable Medical Equipment & Medical Supplies
  • Muskogee, OK
National Provider Identifier
1609405950
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
ALPINE MEDICAL SUPPLY LLC
Practice address
1601 N Main St
Muskogee, OK 74401-4451
Phone
(918) 682-7773
Fax
(918) 775-4654
NPI assigned
Apr 7, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Authorized official

Name
Lindsey Nicole Ketcham
Title
Operations Manager
Phone
(918) 682-7773

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Oxygen Equipment & Supplies (DME) 332BX2000X

Addresses

Primary practice location

1601 N Main St
Muskogee, OK 74401-4451

Mailing address

1601 N Main St
Muskogee, OK 74401-4451
Phone (918) 682-7773

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200511003203 OK DME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Oxygen & Equipment 1052742830 Practice locations: Muskogee, OK

National Provider Directory

National Provider Directory

Locations

1601 N Main St
Muskogee, OK 74401
Phone (918) 682-7773

738 8th St
Warner, OK 74469
Phone (918) 463-2055

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1586217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728864000000",
    "number": "1609405950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 N MAIN ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744014451",
            "telephone_number": "918-682-7773",
            "fax_number": "918-775-4654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 N MAIN ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744014451",
            "telephone_number": "918-682-7773",
            "fax_number": "918-775-4654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPINE MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-07",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A",
        "authorized_official_last_name": "KETCHAM",
        "authorized_official_first_name": "LINDSEY",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "918-682-7773"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; 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.