Queen City Med Mart LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

QUEEN CITY MED MART LLC

Practice address

3737 S Smithville Rd
Kettering, OH 45420-1588

Phone

(937) 256-0000

Fax

(937) 256-0844

NPI assigned

Jul 3, 2006

Organization subpart

No

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

Authorized official

Name

Mr. David P Fesman

Title

President

Phone

(513) 733-8100

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• Queen City Med Mart LLC

  • Durable Medical Equipment & Medical Supplies
  • Cincinnati, OH
  • NPI 1891725263

  9234258229

  Same PAC ID

Tax ID family

Queen City Med Mart Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Queen City Med Mart Inc

  • Durable Medical Equipment & Medical Supplies
  • Clayton, OH
  • NPI 1568492809
  NPD tax ID
• Queen City Med Mart LLC

  • Chore Provider
  • Cincinnati, OH
  • NPI 1215727821
  NPD tax ID
• Queen City Med Mart LLC

  • Durable Medical Equipment & Medical Supplies
  • Cincinnati, OH
  • NPI 1891725263
  NPD tax ID

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775088000000",
    "number": "1891725115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10780 READING RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452412531",
            "telephone_number": "513-563-4855",
            "fax_number": "513-563-4855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 S SMITHVILLE RD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454201588",
            "telephone_number": "937-256-0000",
            "fax_number": "937-256-0844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEEN CITY MED MART LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A",
        "authorized_official_last_name": "FESMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "513-733-8100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0296200",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacy Marie Purvis
• Audra Puzio, PA-C
• Ryan Pyles-Dodds
• Brooke Pyles, MSSA, LSW
• Nazneen M Quadri, M.D.
• Delaney Quinn
• R V Zimmer, D.C., Inc
• Niranshiny Rahunanthan
• Randall R Ralston, M.D.
• Parasram Ramdeo, MD

• Durable Medical Equipment & Medical Supplies in Kettering, OH
• Providers in Kettering, OH by specialty
• Durable Medical Equipment & Medical Supplies in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2026; 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.