Medically Yours, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

081763 Issued in IA

Legal business name

MEDICALLY YOURS, INC.

Practice address

2212 Ingersoll Ave
Des Moines, IA 50312-5230

Phone

(515) 270-0725

Fax

(515) 270-0166

NPI assigned

Nov 30, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Sandra Kay Mastrofski, RN

Title

Vice President

Phone

(515) 270-0725

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760559017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2212 INGERSOLL AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503125230",
            "telephone_number": "515-270-0725",
            "fax_number": "515-270-0166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2212 INGERSOLL AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503125230",
            "telephone_number": "515-270-0725",
            "fax_number": "515-270-0166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICALLY YOURS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MASTROFSKI",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "515-270-0725",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IA",
            "license": "081763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0136721",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• 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.