Alpha Medical, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ALPHA MEDICAL, LLC

Practice address

338 Broadway St Ste 312
Cape Girardeau, MO 63701-7331

Phone

(573) 381-0820

NPI assigned

Feb 5, 2019

Organization subpart

No

Name

Kenneth CallisNPI 1316159114

Title

Owner

Phone

(573) 450-6753

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth E Callis, PHD

  • Cognitive & Behavioral Psychologist
  • Cape Girardeau, MO
  • NPI 1316159114
  NPD Authorized official

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 5, 2019.

{
    "created_epoch": "1549324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554422400000",
    "number": "1821553793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 BROADWAY ST STE 421",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637017331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 BROADWAY ST STE 312",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637017331",
            "telephone_number": "573-381-0820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPHA MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-05",
        "last_updated": "2019-04-05",
        "status": "A",
        "authorized_official_last_name": "CALLIS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-450-6753"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Cape Girardeau, MO
• Durable Medical Equipment & Medical Supplies in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2019; 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.