Organization Active NPI

Mobility Professionals, Inc.

  • Customized Equipment (DME)
  • Lake Forest, CA
National Provider Identifier
1003156274
Registry record updated May 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
License
3535099 Issued in CA
Legal business name
MOBILITY PROFESSIONALS, INC.
Practice address
12 Rancho Cir
Lake Forest, CA 92630-8325
Phone
(949) 716-3694
Fax
(949) 716-1235
NPI assigned
Feb 25, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2017

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

Authorized official

Name
Mr. Donald Robert Woods
Title
President
Phone
(866) 397-3732

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X 3535099 CA Primary

Addresses

Primary practice location

12 Rancho Cir
Lake Forest, CA 92630-8325

Mailing address

12 Rancho Cir
Lake Forest, CA 92630-8325
Phone (949) 716-3694

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140220000404 CA DME Supplier - Medical Supply Company 0446480362 Practice locations: Lake Forest, CA

National Provider Directory

National Provider Directory

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

24 Rancho Cir
Lake Forest, CA 92630
Phone (949) 716-1235

NPI Registry JSON

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

{
    "created_epoch": "1361750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494547200000",
    "number": "1003156274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 RANCHO CIR",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926308325",
            "telephone_number": "949-716-3694",
            "fax_number": "949-716-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 RANCHO CIR",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926308325",
            "telephone_number": "949-716-3694",
            "fax_number": "949-716-1235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILITY PROFESSIONALS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-25",
        "last_updated": "2017-05-12",
        "status": "A",
        "authorized_official_last_name": "WOODS",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "866-397-3732",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "CA",
            "license": "3535099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.