MEDICARE: JKM DME, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BX2000X	Oxygen Equipment & Supplies (DME)

General Provider Information

NPI Number	:	1003697731
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JKM DME, INC

Provider Business Mailing Address
First Line	:	2 W 18TH ST
Second Line	:
City	:	FORT SCOTT
State	:	KS
Zip	:	66701-3177
Country	:	US
Telephone Number	:	620-223-4141
Fax Number	:	620-223-4144

Provider Business Practice Location Address
First Line	:	7329 W 97TH ST
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66212-2210
Country	:	US
Telephone Number	:	913-538-5269
Fax Number	:	620-273-0762

Authorized Official
Title or Position	:	MANAGER
Name	:	KIMBERLY K PHILLIPS
Credential	:
Telephone Number	:	620-223-4141

Provider Enumeration Date	:	10/09/2023
Last Update Date	:	10/09/2025

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