Mobile MD, LLC

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

Legal business name

MOBILE MD, LLC

Practice address

746 Royal Springs LN
Grovetown, GA 30813-4534

Phone

(706) 589-1990

NPI assigned

Mar 29, 2019

Organization subpart

No

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

Authorized official

Name

Kim Martin

Title

Manager

Phone

(706) 863-0200

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1073074175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "746 ROYAL SPRINGS LN",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308134534",
            "telephone_number": "706-589-1990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "746 ROYAL SPRINGS LN",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308134534",
            "telephone_number": "706-589-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-29",
        "last_updated": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "706-863-0200"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Augusta",
            "affiliation": "Y",
            "affiliationName": "Augusta Obstetrics and Gynecology Specialists, LLC",
            "address_1": "2806 Hillcreek Dr",
            "city": "Augusta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "309096484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Chasity Miles, CNA
• Amanda Nicole Miller, LPC
• Cortlin Yancey Miller, OTR/L
• Denise Miller, NP
• Rosamella Miller, LPC
• Desiree Mock, NP
• Thomas Joseph Moreno, DDS
• Abigail Morgan
• Claudia Theresa Morin, OTR
• Shequita Morris, APRN, MSN, PMHNP-BC

• Gynecology Physician in Grovetown, GA
• Providers in Grovetown, GA by specialty
• Gynecology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.