NPIMap

Organization Active NPI

Stateserv Medical, LLC

  • Oxygen Equipment & Supplies (DME)
  • Gulfport, MS
National Provider Identifier
1679349641
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
Legal business name
STATESERV MEDICAL, LLC
Practice address
1235 Pass Road
Gulfport, MS 39501
Phone
(904) 219-1275
NPI assigned
Nov 30, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Authorized official

Name
Christopher Roode
Title
Coo
Phone
(877) 633-7250

Specialties & licenses 1

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

Addresses

Primary practice location

1235 Pass Road
Gulfport, MS 39501

Mailing address

1201 South Alma School Road
Suite 4000
Mesa, AZ 85210
Phone (877) 633-7250

Other names 1

  • Gulfport Other name

National Provider Directory

National Provider Directory
Tax ID family
Stateserv Medical LLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

1235 Pass Rd
Gulfport, MS 39501
Phone (904) 219-1275

NPI Registry JSON

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

{
    "created_epoch": "1701302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1679349641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 SOUTH ALMA SCHOOL ROAD",
            "address_2": "SUITE 4000",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85210",
            "telephone_number": "877-633-7250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 PASS ROAD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39501",
            "telephone_number": "904-219-1275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATESERV MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-30",
        "last_updated": "2023-11-30",
        "status": "A",
        "authorized_official_last_name": "ROODE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "877-633-7250"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gulfport",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.