NPIMap

Organization Active NPI

Reliable Medical Supply LLC

  • Durable Medical Equipment & Medical Supplies
  • Smyrna, TN
National Provider Identifier
1730893868
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
RELIABLE MEDICAL SUPPLY LLC
Practice address
871 Seven Oaks Blvd Ste 250
Smyrna, TN 37167-6483
Phone
(615) 445-7466
Fax
(629) 468-2074
NPI assigned
Jan 12, 2023
Last updated
Jul 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Authorized official

Name
Kiley Ann Russell
Title
Senior Director of Payor Relations
Phone
(296) 252-8211

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

871 Seven Oaks Blvd Ste 250
Smyrna, TN 37167-6483

Mailing address

9495 Winnetka Ave N Ste 200
Brooklyn Park, MN 55445-1618
Phone (629) 282-8211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230914000661 TN DME Supplier - Medical Supply Company 0345367173 Practice locations: Smyrna, TN

Other NPIs with the same Medicare PAC ID 13

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 13

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Reliable Medical Supply LLC871 Seven Oaks Blvd, Smyrna, TN 37167-6483(615) 445-7466 Power Operated Vehicles (Scooters)|Wheelchairs (Standard Manual)|Wheelchairs (Standard Manual Related Accessories)|Wheelchairs (Standard Power)|Wheelchairs (Standard Power Related Accessories)|Wheelchairs (Complex Rehabilitative Manual)|Wheelchairs (Complex Rehab Manual Rel Accessories)|Wheelchairs… Does not accept assignmentParticipating since May 19, 2022

National Provider Directory

National Provider Directory
Tax ID family
Reliable Medical Supply LLC17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1673481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721692800000",
    "number": "1730893868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9495 WINNETKA AVE N STE 200",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554451618",
            "telephone_number": "629-282-8211",
            "fax_number": "763-255-3972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "871 SEVEN OAKS BLVD STE 250",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371676483",
            "telephone_number": "615-445-7466",
            "fax_number": "629-468-2074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RELIABLE MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-12",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "KILEY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "SENIOR DIRECTOR OF PAYOR RELATIONS",
        "authorized_official_telephone_number": "296-252-8211"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.