Active NPI
Saint John Health System
- Durable Medical Equipment & Medical Supplies
- Kokomo, IN
National Provider Identifier
1851614192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 69000392A
- Legal business name
- SAINT JOHN HEALTH SYSTEM
- Doing business as
- Saint John's Medical Supplies
- Practice address
- 1907 W Sycamore St
3Rd Floor
Kokomo, IN 46901-5148 - Phone
- (765) 236-8300
- Fax
- (765) 236-8302
- NPI assigned
- Mar 1, 2010
- Organization subpart
- Yes
- Parent organization
- ST.VINCENT MADISON COUNTY HEALTH SYSTEM INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Dante Otis Phillips
- Title
- DME Consultant
- Phone
- (765) 683-3201
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 69000392A | IN | Primary |
Addresses
Primary practice location
1907 W Sycamore St
3Rd Floor
Kokomo, IN 46901-5148
Mailing address
2015 Jackson St
RM 248
Anderson, IN 46016-4337
Phone (765) 683-3201
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200408950A | Medicaid | IN | |
| 000000247286 | Other | IN | ANTHEM |
Other names 1
- Saint John's Medical Supplies
National Provider Directory
National Provider Directory- Part of
- Patrick M McGill MD
Locations
2015 Jackson St
Rm 248
Anderson, IN 46016
2130 W Sycamore St
Ste 120
Kokomo, IN 46901
Phone (765) 236-8300
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267401600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1324339200000",
"number": "1851614192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2015 JACKSON ST",
"address_2": "RM 248",
"city": "ANDERSON",
"state": "IN",
"postal_code": "460164337",
"telephone_number": "765-683-3201",
"fax_number": "765-646-8625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1907 W SYCAMORE ST",
"address_2": "3RD FLOOR",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469015148",
"telephone_number": "765-236-8300",
"fax_number": "765-236-8302"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAINT JOHN HEALTH SYSTEM",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "ST.VINCENT MADISON COUNTY HEALTH SYSTEM INC",
"enumeration_date": "2010-03-01",
"last_updated": "2011-12-20",
"status": "A",
"authorized_official_last_name": "PHILLIPS",
"authorized_official_first_name": "DANTE",
"authorized_official_middle_name": "OTIS",
"authorized_official_title_or_position": "DME CONSULTANT",
"authorized_official_telephone_number": "765-683-3201",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "IN",
"license": "69000392A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200408950A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000247286",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Saint John's Medical Supplies",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Kokomo, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.