Black Belt Medical Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

BLACK BELT MEDICAL INC.

Practice address

1004 Jeff Davis Ave
Selma, AL 36701-4519

Phone

(334) 872-9721

Fax

(334) 874-4923

NPI assigned

May 3, 2006

Last updated

Mar 27, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jerry Carl Jr.

Title

Ceo/President

Phone

(251) 633-8090

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206576000000",
    "number": "1689632838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7856 WESTSIDE PARK DR",
            "address_2": "SUITE C",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366958541",
            "telephone_number": "251-633-8090",
            "fax_number": "251-633-6941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 JEFF DAVIS AVE",
            "city": "SELMA",
            "state": "AL",
            "postal_code": "367014519",
            "telephone_number": "334-872-9721",
            "fax_number": "334-874-4923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK BELT MEDICAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2008-03-27",
        "status": "A",
        "authorized_official_last_name": "CARL",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "251-633-8090",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51516028",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Bio-Medical Applications of Alabama, Inc. (FMC Dialysis Services Selma)
• John C. Blackenburg, O.D.
• Melissa L Blackmon, OT
• Donald W Blanton, PHD
• Garrett Blanton
• Blue Ridge Healthcare Selma LLC

• Durable Medical Equipment & Medical Supplies in Selma, AL
• Providers in Selma, AL by specialty
• Durable Medical Equipment & Medical Supplies in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.