Vistacare Health Services, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

0000000612 Issued in TN

Legal business name

VISTACARE HEALTH SERVICES, INC

Practice address

8813 Chaffee Rd
Brunswick, TN 38014-0000

Phone

(901) 373-8831

Fax

(901) 373-7655

NPI assigned

May 27, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Paul Thomas Webb

Title

President/Ceo

Phone

(901) 373-8831

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992708473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277",
            "city": "BRUNSWICK",
            "state": "TN",
            "postal_code": "380140277",
            "telephone_number": "901-373-8831",
            "fax_number": "901-373-7655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8813 CHAFFEE RD",
            "city": "BRUNSWICK",
            "state": "TN",
            "postal_code": "380140000",
            "telephone_number": "901-373-8831",
            "fax_number": "901-373-7655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTACARE HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEBB",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "901-373-8831",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TN",
            "license": "0000000612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME LICENSE",
            "identifier": "0000000612",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1452522",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3144888",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Martha Anetra Matthews-Shaw, PHARM.D
• Kayla Brooke Murphree, RD
• O2 Medical,LLC
• Wilber Mitchell Pleasants, PHARMD.
• Restore RX Inc

• All providers in Brunswick, TN
• Durable Medical Equipment & Medical Supplies in Tennessee

• 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.

Verify at the official NPI Registry.