Provider Plus Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

14868971 Issued in MO

Legal business name

PROVIDER PLUS INC

Practice address

1813 Heritage Hills Dr
Washington, MO 63090-4624

Phone

(636) 390-4200

Fax

(636) 390-4246

NPI assigned

Apr 3, 2007

Organization subpart

No

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

Authorized official

Name

Wendy Russalesi

Title

Cco

Phone

(484) 246-9499

Specialties & licenses 1

Addresses

Other identifiers 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Med Star Surgical & Breathing Equipment, Inc.

  dba Adapthealth NY

  • Durable Medical Equipment & Medical Supplies
  • New York, NY
  • NPI 1003239740

  Member Of

  NPD member

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760486400000",
    "number": "1699896720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 E NORTH LN STE 5075",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194282490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1813 HERITAGE HILLS DR",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630904624",
            "telephone_number": "636-390-4200",
            "fax_number": "636-390-4246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDER PLUS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A",
        "authorized_official_last_name": "RUSSALESI",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "CCO",
        "authorized_official_telephone_number": "484-246-9499"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MO",
            "license": "14868971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "626339808",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jillian Poretti, RD LD
• Gregory A. Potts, M.D.
• Pro Fitness & Rehab LLC
• Professional Counseling Connections
• Prorehab, PC (Athletico Physical Therapy)
• Quest Diagnostics Clinical Laboratories Inc
• Rashid Mahmood Qureshi, MD
• Michael Edward Radetic, D.D.S.
• Christina Radosevich, APRN, FNP-BC
• Aruna Rajagopalan Rajagopalan, DDS

• Durable Medical Equipment & Medical Supplies in Washington, MO
• Providers in Washington, MO by specialty
• Durable Medical Equipment & Medical Supplies in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; 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.