Missouri Breaks Industries Research, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MISSOURI BREAKS INDUSTRIES RESEARCH, INC.

Practice address

118 S Willow St
Eagle Butte, SD 57625

Phone

(605) 964-3418

Fax

(605) 964-3415

NPI assigned

Jan 12, 2006

Organization subpart

No

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

Authorized official

Name

Blaine O'Leary

Title

Manager

Phone

(605) 964-3418

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Missouri Breaks Durable Medical Equipment Doing business as

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

Tax ID family

Missouri Breaks Durable Medical Equipment2 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.

• Missouri Breaks Medical

  • Clinic/Center
  • Timber Lake, SD
  • NPI 1235329053
  NPD tax ID

Practitioners 1

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

• Rae Alison O'Leary, RRT

  • Registered Respiratory Therapist
  • Timber Lake, SD
  • NPI 1952501074
  NPD (past)

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1699754143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1824",
            "city": "EAGLE BUTTE",
            "state": "SD",
            "postal_code": "576251824",
            "telephone_number": "605-964-3418",
            "fax_number": "605-964-3415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 S WILLOW ST",
            "city": "EAGLE BUTTE",
            "state": "SD",
            "postal_code": "57625",
            "telephone_number": "605-964-3418",
            "fax_number": "605-964-3415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOURI BREAKS INDUSTRIES RESEARCH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-12",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "O'LEARY",
        "authorized_official_first_name": "BLAINE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "605-964-3418"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTA CARE",
            "identifier": "9218369",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9161950",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUESHIELD",
            "identifier": "4995628",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Missouri Breaks Durable Medical Equipment",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Heather Leigh Martin, R.N.
• Mildred Martinez-Santos, RN
• Medicine Wheel Village
• Lita Marie Miller, RN
• Tony L Miller, RN
• Eunice Rose Montreal, REGISTERED NURSE
• Madison Claire Moore, RN
• Dreemis Moran
• Shawn Catherine Morse, RN
• Shantel Norman, DPT

• Durable Medical Equipment & Medical Supplies in Eagle Butte, SD
• Providers in Eagle Butte, SD by specialty
• Durable Medical Equipment & Medical Supplies in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; 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.