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1083005375 NPI number — OMS REHAB, LLC

NPI Number: 1083005375
Health Care Provider/Practitioner: OMS REHAB, LLC

Information about “1083005375” NPI (OMS REHAB, LLC) exists in 1083005375 in HTML format HTML  |  1083005375 in plain Text format TXT  |  1083005375 in PDF (Portable Document Format) PDF  |  1083005375 in an XML format XML  formats.

NPI Number : 1083005375 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1083005375",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "OMS REHAB, LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3750 PRIORITY WAY SOUTH DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "INDIANAPOLIS",
    "MailingAddressStateName": "IN",
    "MailingAddressPostalCode": "46240-3831",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "877-813-0205",
    "MailingAddressFaxNumber": "877-604-3468",
    "FirstLinePracticeLocationAddress": "9678 MARION RIDGE DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "KANSAS CITY",
    "PracticeLocationAddressStateName": "MO",
    "PracticeLocationAddressPostalCode": "64137",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "816-783-5003",
    "PracticeLocationAddressFaxNumber": "816-783-5004",
    "EnumerationDate": "02/09/2015",
    "LastUpdateDate": "06/20/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "DELEON",
    "AuthorizedOfficialFirstName": "RICHARD",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "COMPLIANCE COORDINATOR",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "317-436-6178",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "332BN1400X",
          "TaxonomyName": "Nursing Facility Supplies (DME)",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "335E00000X",
          "TaxonomyName": "Prosthetic/Orthotic Supplier",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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