NPIMap

Organization Active NPI

Dr Medical LLC

  • Prosthetic/Orthotic Supplier
  • Willimantic, CT
National Provider Identifier
1679912927
Registry record updated Jun 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
C16275 Issued in MA
Legal business name
DR MEDICAL LLC
Practice address
322 Main St Ste 1W
Willimantic, CT 06226-3152
Phone
(508) 222-1972
Fax
(508) 222-6900
NPI assigned
Jun 20, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2013

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

Authorized official

Name
Mr. Daryl Reuter, BOC ORTHOTISTNPI 1669073664
Title
President/Owner
Phone
(502) 222-1972

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X C16275 MA
Prosthetic/Orthotic Supplier 335E00000X C16275 MA Primary

Addresses

Primary practice location

322 Main St Ste 1W
Willimantic, CT 06226-3152

Mailing address

322 Main St Ste 1W
Willimantic, CT 06226-3152
Phone (508) 222-1972

Other names 1

  • DR Medical LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dr Medical LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

322 Main St
Ste 1W
Willimantic, CT 06226
Phone (508) 222-1972

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": "1371686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371686400000",
    "number": "1679912927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 MAIN ST STE 1W",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062263152",
            "telephone_number": "508-222-1972",
            "fax_number": "508-222-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 MAIN ST STE 1W",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062263152",
            "telephone_number": "508-222-1972",
            "fax_number": "508-222-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-20",
        "last_updated": "2013-06-20",
        "status": "A",
        "authorized_official_last_name": "REUTER",
        "authorized_official_first_name": "DARYL",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "502-222-1972",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BOC ORTHOTIST"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MA",
            "license": "C16275",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "MA",
            "license": "C16275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DR Medical LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Willimantic, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2013; 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.