NPIMap

Organization Active NPI

Family Medical Supply LLC

  • Oxygen Equipment & Supplies (DME)
  • Smithfield, NC
National Provider Identifier
1861597791
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
License
00695 Issued in NC
Legal business name
FAMILY MEDICAL SUPPLY LLC
Practice address
631 N Brightleaf Blvd
Smithfield, NC 27577-4408
Phone
(919) 938-1991
Fax
(919) 938-1925
NPI assigned
Sep 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Authorized official

Name
Wendy Russalesi
Title
Cco
Phone
(484) 246-9499

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Customized Equipment (DME) 332BC3200X
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X
Oxygen Equipment & Supplies (DME) 332BX2000X 00695 NC Primary

Addresses

Primary practice location

631 N Brightleaf Blvd
Smithfield, NC 27577-4408

Mailing address

555 E North LN Ste 5075
Conshohocken, PA 19428-2490

Other identifiers 1

IdentifierTypeStateIssuer
0490TOtherNCBCBS PROVIDER NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930057279 NC DME Supplier - Medical Supply CompanyDME Supplier - Medical Supply Company With Orthotic PersonnelDME Supplier - Medical Supply Company With Prosthetic PersonnelDME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Oxygen & Equipment 2062539620 Practice locations: Smithfield, NC

Other NPIs with the same Medicare PAC ID 16

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

View all 16

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
Family Medical Supply LLC631 N Brightleaf Blvd, Smithfield, NC 27577-4408(919) 938-1991 Commodes, Urinals, Bedpans|Continuous Passive Motion (CPM) Devices|Blood Glucose Monitors/Supplies (Non-Mail Order)|Gastric Suction Pumps|Heat & Cold Applications|Hospital Beds (Electric)|Hospital Beds (Manual)|Negative Pressure Wound Therapy Pumps/Supplies|Pneumatic Compression Devices and/or Supp… Does not accept assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Family Medical Supply LLC20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

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

View all 19

Locations

631 N Brightleaf Blvd
Smithfield, NC 27577
Phone (919) 938-1991

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760313600000",
    "number": "1861597791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 E NORTH LN STE 5075",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194282490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 N BRIGHTLEAF BLVD",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275774408",
            "telephone_number": "919-938-1991",
            "fax_number": "919-938-1925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A",
        "authorized_official_last_name": "RUSSALESI",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "CCO",
        "authorized_official_telephone_number": "484-246-9499"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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": "NC",
            "license": "00695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "0490T",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithfield, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2025; 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.