INNOVATIVE MEDICAL SUPPLY, LLC
NPI 1679570121
Durable Medical Equipment & Medical Supplies in Moore, OK

NPI Status: Active since June 30, 2005

Contact Information

1501 SE 4TH ST
SUITE D
MOORE, OK
ZIP 73160
Phone: (405) 799-8855
Fax: (405) 799-8860

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  • Organization
  • Durable Medical Equipment & Medical Supp...
  • Accepts Insurance
  • Medicare Supplier
  • Does Not Accept Medicare Approved Payment

About INNOVATIVE MEDICAL SUPPLY, LLC

This page provides the complete NPI Profile along with additional information for Innovative Medical Supply, Llc, a provider established in Moore, Oklahoma operating as a Durable Medical Equipment & Medical Supplies. The healthcare provider is registered in the NPI registry with number 1679570121 assigned on June 2005. The practitioner's primary taxonomy code is 332B00000X. The provider is registered as an organization and their NPI record was last updated one year ago. The provider's . The authorized official of this NPI record is Mr. Brian K Berry (Member)

NPI
1679570121
Provider Legal Name
INNOVATIVE MEDICAL SUPPLY, LLC
Other Organization Name
Other Name Type
(6)
Entity Type
Organization
Location Address
1501 SE 4TH ST SUITE D MOORE, OK 73160
Location Phone
(405) 799-8855
Location Fax
(405) 799-8860
Mailing Address
1501 SE 4TH ST MOORE, OK 73160
Mailing Phone
(405) 799-8855
Mailing Fax
(405) 799-8860
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-30-2005
Last Update Date
08-27-2025
Code Navigator



Innovative Medical Supply, Llc is a medicare supplier with PTAN 20589257 who does not accept Medicare assignment for all durable medical equipment and supplies. The provider may not accept the Medicare allowable as payment in full and may collect additional payment directly from the patient, and/or charge more than the Medicare allowable.The supplier carries the following product categories: Canes and/or Crutches or Walkers or Enteral Nutrients or Lymphedema Compression Treatment Items.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Durable Medical Equipment & Medical Supplies

Taxonomy Code
332B00000X
Type
Suppliers
Taxonomy Description
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA (QualChoice) - POS
  • Complete Gold - PPO
  • Complete Gold + Vision + Adult Dental - PPO
  • Connected Silver - PPO
  • Connected Silver (QualChoice) - POS
  • Connected Silver (QualChoice) + Vision + Adult Dental - POS
  • Connected Silver (QualChoiceLife) - PPO
  • Connected Silver (QualChoiceLife) + Vision + Adult Dental - PPO
  • Connected Silver + Vision + Adult Dental - PPO
  • Elite Bronze - PPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Elite Gold - PPO
  • Elite Gold + Vision + Adult Dental - PPO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options - PPO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - PPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
  • Everyday Bronze - PPO
  • Everyday Bronze + Vision + Adult Dental - PPO
  • Blue Advantage Bronze PPO? 202 - PPO
  • Blue Advantage Bronze PPO? 203 - PPO
  • Blue Advantage Bronze PPO? Standard - PPO
  • Blue Advantage Gold PPO? 309 - PPO
  • Blue Advantage Gold PPO? 604 - PPO
  • Blue Advantage Gold PPO? Standard - PPO
  • Blue Advantage Silver PPO? 204 - PPO
  • Blue Advantage Silver PPO? 501 - PPO
  • Blue Advantage Silver PPO? Standard - PPO
  • Blue Preferred Bronze PPO? Standard - PPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. BRIAN K BERRY

Authorized Official Title
MEMBER
Authorized Official Phone
(405) 799-8855

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
2023000AMEDICAID (05)OK 
209078400OTHER (01)OKDEPT OF LABOR PROVIDER #
20536475001OTHER (01)OKTRICARE PROVIDER NUMBER

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN
20589257
Accepts Medicare Assignment
NO
Specialities List
Medical Supply Company Other.
Competitive Bidding
NO

Supplies List

  • Canes and/or Crutches - Standard Canes, Quad Canes, Offset Canes, Standard Crutches, Forearm Crutches
  • Walkers - Standard Walkers, Wheeled Walkers, Folding Walker
  • Enteral Nutrients - Enteral formula
  • Lymphedema Compression Treatment Items -

Reviews for INNOVATIVE MEDICAL SUPPLY, LLC

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1679570121, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
9
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
7
Unchanged
Pos 7
0
Doubled → 0
Pos 8
1
Unchanged
Pos 9
2
Doubled → 4
Check
1
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 5 → 10 → 1 0 → 0 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 1 + 4 + 9 + 1 + 0 + 7 + 0 + 1 + 4 + 24 = 59

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 59 is 60. The difference is the calculated check digit.

60 - 59 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1679570121.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Emergency Response System Companies
1501 SE 4TH ST
MOORE, OK 73160

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1679570121, enumerated as an "organization" on June 30, 2005.

The provider is located at 1501 SE 4TH ST SUITE D MOORE, OK 73160 and the phone number is (405) 799-8855.

Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to verify.