NPIMap

Organization Active NPI

Medical Equipment Distributors of Tenessee

Doing business as Medical Mart

  • Durable Medical Equipment & Medical Supplies
  • Jasper, TN
National Provider Identifier
1740402296
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
0000000691 Issued in TN
Legal business name
MEDICAL EQUIPMENT DISTRIBUTORS OF TENESSEE
Doing business as
Medical Mart
Practice address
980 Highway 28
Suite 404
Jasper, TN 37347-3695
Phone
(423) 942-2556
Fax
(423) 942-2442
NPI assigned
May 3, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Jason John Hames
Title
Cheif Financial Officer
Phone
(865) 380-0819

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 0000000691 TN Primary

Addresses

Primary practice location

980 Highway 28
Suite 404
Jasper, TN 37347-3695

Mailing address

742 W Lamar Alexander Pkwy
Maryville, TN 37801
Phone (865) 380-0819

Other identifiers 1

IdentifierTypeStateIssuer
1454237MedicaidTN

Other names 1

  • Medical Mart Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Medical Equipment Distributors of Tenessee2 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

980 Highway 28
Ste 404
Jasper, TN 37347
Phone (423) 942-2556

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740402296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "742 W LAMAR ALEXANDER PKWY",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "37801",
            "telephone_number": "865-380-0819",
            "fax_number": "865-380-0890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 HIGHWAY 28",
            "address_2": "SUITE 404",
            "city": "JASPER",
            "state": "TN",
            "postal_code": "373473695",
            "telephone_number": "423-942-2556",
            "fax_number": "423-942-2442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL EQUIPMENT DISTRIBUTORS OF TENESSEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAMES",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "CHEIF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "865-380-0819",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TN",
            "license": "0000000691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1454237",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Mart",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jasper, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.