One Source Medical Group, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ONE SOURCE MEDICAL GROUP, LLC

Practice address

6205 Abercorn St Ste 101C
Savannah, GA 31405-5540

Phone

(866) 834-7473

Fax

(877) 490-9111

NPI assigned

Apr 12, 2019

Organization subpart

Yes

Parent organization

ONE SOURCE MEDICAL GROUP, LLCAs reported in NPPES

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

Authorized official

Name

Daniel J Robichaud

Title

Ceo

Phone

(866) 834-7473

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

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

• One Source Medical Group LLC

  • Durable Medical Equipment & Medical Supplies
  • Tampa, FL
  • NPI 1366653545

  5597960930

  Same PAC ID
• One Source Medical Group LLC

  • Durable Medical Equipment & Medical Supplies
  • San Antonio, TX
  • NPI 1841558160

  5597960930

  Same PAC ID

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

Tax ID family

One Source Medical Group LLC3 organizations share this tax ID, including this one

Part of

One Source Medical Group LLC

Other organizations with this tax ID 2

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

• One Source Medical Group LLC

  • Durable Medical Equipment & Medical Supplies
  • Tampa, FL
  • NPI 1366653545
  NPD tax ID
• One Source Medical Group LLC

  • Durable Medical Equipment & Medical Supplies
  • San Antonio, TX
  • NPI 1841558160
  NPD tax ID

Locations

Practitioners 1

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

• Christopher Vejil, MPH

  • Health Educator
  • San Antonio, TX
  • NPI 1174912190
  NPD (past)

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

{
    "created_epoch": "1555027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708560000000",
    "number": "1902369267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13910 LYNMAR BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336263123",
            "telephone_number": "866-834-7473",
            "fax_number": "877-490-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6205 ABERCORN ST STE 101C",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314055540",
            "telephone_number": "866-834-7473",
            "fax_number": "877-490-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONE SOURCE MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ONE SOURCE MEDICAL GROUP, LLC",
        "enumeration_date": "2019-04-12",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A",
        "authorized_official_last_name": "ROBICHAUD",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "866-834-7473"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003228865A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany R. Olivo, NP
• Olha Oliynyk
• Jennifer Lynn Olmstead, CSFA
• Olukemi Olubajo, PHD, RD, LD
• One Love Homecare LLC
• One Step Forward, LLC
• One Step Foward, LLC.
• Cameron Elizabeth Oneal, RPH
• Onewell Health of Georgia, LLC
• Onsite Medical Imaging

• Durable Medical Equipment & Medical Supplies in Savannah, GA
• Providers in Savannah, GA by specialty
• Durable Medical Equipment & Medical Supplies in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; 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.