Active NPI
Medical Equipment Distributors of Tennessee, Inc
- Durable Medical Equipment & Medical Supplies
- Maryville, TN
National Provider Identifier
1972561066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 0000000691
- Legal business name
- MEDICAL EQUIPMENT DISTRIBUTORS OF TENNESSEE, INC
- Practice address
- 742 W Lamar Alexander Pkwy
Maryville, TN 37801-3913 - Phone
- (865) 380-0819
- Fax
- (865) 380-0890
- NPI assigned
- May 1, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Jason John Hames
- Title
- Vice President
- Phone
- (865) 380-0819
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 0000000691 | TN | Primary |
Addresses
Primary practice location
742 W Lamar Alexander Pkwy
Maryville, TN 37801-3913
Mailing address
742 W Lamar Alexander Pkwy
Maryville, TN 37801-3913
Phone (865) 380-0819
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3141795 | Other | TN | BLUE CROSS BLUE SHIELD |
| 1454237 | Medicaid | TN | |
| 3141795 | Other | TN | BLUECARE TENNCARE |
Other names 1
- Medical Mart
National Provider Directory
National Provider Directory- Tax ID family
- Medical Equipment Distributors of Tenessee
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Durable Medical Equipment & Medical Supplies
- Jasper, TN
- NPI 1740402296
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146441600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1972561066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "742 W LAMAR ALEXANDER PKWY",
"city": "MARYVILLE",
"state": "TN",
"postal_code": "378013913",
"telephone_number": "865-380-0819",
"fax_number": "865-380-0890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "742 W LAMAR ALEXANDER PKWY",
"city": "MARYVILLE",
"state": "TN",
"postal_code": "378013913",
"telephone_number": "865-380-0819",
"fax_number": "865-380-0890"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDICAL EQUIPMENT DISTRIBUTORS OF TENNESSEE, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-01",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "HAMES",
"authorized_official_first_name": "JASON",
"authorized_official_middle_name": "JOHN",
"authorized_official_title_or_position": "VICE PRESIDENT",
"authorized_official_telephone_number": "865-380-0819",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "TN",
"license": "0000000691",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "3141795",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1454237",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECARE TENNCARE",
"identifier": "3141795",
"state": "TN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Medical Mart",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Maryville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.