Martha Dale Kristiansen

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

057128480 Issued in MS

Legal business name

MARTHA DALE KRISTIANSEN

Doing business as

MAK MEDICAL EQUIPMENT & RESPIRATORY

Practice address

1413 Aston Ave
McComb, MS 39648-2827

Phone

(601) 684-5115

Fax

(601) 684-5116

NPI assigned

Nov 1, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Martha Dale Kristiansen

Title

Owner

Phone

(601) 684-5115

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• MAK MEDICAL EQUIPMENT & RESPIRATORY Doing business as

Locations

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

{
    "created_epoch": "1193875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218499200000",
    "number": "1629257084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 ASTON AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482827",
            "telephone_number": "601-684-5115",
            "fax_number": "601-684-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 ASTON AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482827",
            "telephone_number": "601-684-5115",
            "fax_number": "601-684-5116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTHA DALE KRISTIANSEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-01",
        "last_updated": "2008-08-12",
        "status": "A",
        "authorized_official_last_name": "KRISTIANSEN",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-684-5115",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "MS",
            "license": "057128480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ABP",
            "identifier": "9000",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00440487",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAK MEDICAL EQUIPMENT & RESPIRATORY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christie Magee, LSW
• Magnolia Family Medicine, PLLC
• Ivan Kai Makiyama, DO
• Angel Marshall
• Debra Ann Marshall
• Irene Martin, CFNP
• Kassandria Martin
• Kelly H Martin, DPT,ATC
• Melissa Martin
• Maxem Health Urgent Care McComb

• Oxygen Equipment & Supplies (DME) in McComb, MS
• Providers in McComb, MS by specialty
• Oxygen Equipment & Supplies (DME) in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.