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Organization Active NPI

Gaithersburg Durable Medical Equipment

  • Durable Medical Equipment & Medical Supplies
  • Gaithersburg, MD
National Provider Identifier
1790990190
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
GAITHERSBURG DURABLE MEDICAL EQUIPMENT
Practice address
18600 Phoebe Way
Gaithersburg, MD 20879-1755
Phone
(240) 888-3679
NPI assigned
May 11, 2007
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
Kennisha Inez Shepherd
Title
Owner
Phone
(240) 888-3679

Specialties & licenses 1

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

Addresses

Primary practice location

18600 Phoebe Way
Gaithersburg, MD 20879-1755

Mailing address

18600 Phoebe Way
Gaithersburg, MD 20879-1755
Phone (240) 888-3679

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790990190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18600 PHOEBE WAY",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208791755",
            "telephone_number": "240-888-3679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18600 PHOEBE WAY",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208791755",
            "telephone_number": "240-888-3679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAITHERSBURG DURABLE MEDICAL EQUIPMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHEPHERD",
        "authorized_official_first_name": "KENNISHA",
        "authorized_official_middle_name": "INEZ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-888-3679"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

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.