1St Mobile Medical Testing, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

1ST MOBILE MEDICAL TESTING, LLC

Practice address

989 Ivydale Dr
Las Cruces, NM 88005-0927

Phone

(575) 496-5551

NPI assigned

Aug 2, 2021

Last updated

Aug 2, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Catherine Louise Wamel, OWNER

Title

Owner

Phone

(575) 496-5551

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1627862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627862400000",
    "number": "1083388235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "989 IVYDALE DR",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880050927",
            "telephone_number": "575-496-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "989 IVYDALE DR",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880050927",
            "telephone_number": "575-496-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1ST MOBILE MEDICAL TESTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-02",
        "last_updated": "2021-08-02",
        "certification_date": "2021-05-11",
        "status": "A",
        "authorized_official_last_name": "WAMEL",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "575-496-5551",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; 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.