NPIMap

Organization Active NPI

Med-South, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Jasper, AL
National Provider Identifier
1871770156
Registry record updated Nov 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
MED-SOUTH, INC.
Practice address
4505 Hwy. 78 E.
Ste. 100
Jasper, AL 35501-3400
Phone
(205) 384-3626
Fax
(205) 384-5526
NPI assigned
Jan 29, 2008
Last updated
Nov 13, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2019

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

Authorized official

Name
Lisa J. Wells, CPCD
Title
Executive Director
Phone
(205) 221-8258

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X NU
Oxygen Equipment & Supplies (DME) 332BX2000X 080255 AL

Addresses

Primary practice location

4505 Hwy. 78 E.
Ste. 100
Jasper, AL 35501-3400

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
108347MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930043580 AL DME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Orthotic PersonnelDME Supplier - Oxygen & EquipmentDME Supplier - Medical Supply CompanyDME Supplier - Medical Supply Company With Orthotic Personnel 4789653809 Practice locations: Jasper, AL

Other NPIs with the same Medicare PAC ID 5

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

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

4505 Highway 78 E
Ste 500
Jasper, AL 35501

NPI Registry JSON

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573603200000",
    "number": "1871770156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 MEDICAL CENTER DR.",
            "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": "4505 HWY. 78 E.",
            "address_2": "STE. 100",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355013400",
            "telephone_number": "205-384-3626",
            "fax_number": "205-384-5526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED-SOUTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-29",
        "last_updated": "2019-11-13",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "205-221-8258",
        "authorized_official_credential": "CPCD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "AL",
            "license": "080255",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108347",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.