NPIMap

Organization Active NPI

Med-South, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Ft. Payne, AL
National Provider Identifier
1770569428
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
137 Issued in AL
Legal business name
MED-SOUTH, INC.
Practice address
1706 Glenn Blvd. SW
Ft. Payne, AL 35968-3543
Phone
(256) 845-3309
Fax
(256) 845-6105
NPI assigned
Dec 15, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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

Authorized official

Name
Lisa J Wells, CPCO
Title
Vice-President Corporate Compliance
Phone
(205) 221-8258

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 137 AL Primary
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X
Oxygen Equipment & Supplies (DME) 332BX2000X 900164 AL

Addresses

Primary practice location

1706 Glenn Blvd. SW
Ft. Payne, AL 35968-3543

Mailing address

406 Medical Center Drive
Jasper, AL 35501-3400
Phone (205) 221-8200

Other identifiers 1

IdentifierTypeStateIssuer
000052881MedicaidAL

Other names 1

  • Duncan Medical Equipment Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930093545 AL DME Supplier - Medical Supply CompanyDME Supplier - Oxygen & EquipmentDME Supplier - Orthotic PersonnelDME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Medical Supply Company With Orthotic Personnel 4789653809 Practice locations: Fort Payne, AL

Other NPIs with the same Medicare PAC ID 5

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

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
Med South, Inc.1706 Glenn Blvd SW, Fort Payne, AL 35968-3543(256) 845-3309 Commodes, Urinals, Bedpans|Continuous Passive Motion (CPM) Devices|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Hospital Beds (Electric)|Hospital Beds (Manual)|Infrared Heating Pads Systems and/or Supplies|Negative Pressure Wound Therapy Pumps/Suppli… Does not accept assignmentParticipating since Jan 1, 2001

National Provider Directory

National Provider Directory
Tax ID family
Med-South Inc-Fairhope13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Member of 1

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

Locations

1506 5th Ave S
Birmingham, AL 35233
Phone (205) 322-5353

NPI Registry JSON

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667347200000",
    "number": "1770569428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 MEDICAL CENTER DRIVE",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355013400",
            "telephone_number": "205-221-8200",
            "fax_number": "205-221-8270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 GLENN BLVD. SW",
            "city": "FT. PAYNE",
            "state": "AL",
            "postal_code": "359683543",
            "telephone_number": "256-845-3309",
            "fax_number": "256-845-6105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED-SOUTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-15",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VICE-PRESIDENT CORPORATE COMPLIANCE",
        "authorized_official_telephone_number": "205-221-8258",
        "authorized_official_credential": "CPCO"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AL",
            "license": "137",
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "AL",
            "license": "900164",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000052881",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Duncan Medical Equipment",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ft. Payne, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; 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.