Mobile Medic LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

SAV 010 Issued in OK

Legal business name

MOBILE MEDIC LLC

Practice address

1305 Winnipeg Dr
Yukon, OK 73099

Phone

(405) 261-6858

NPI assigned

May 29, 2014

Organization subpart

No

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

Authorized official

Name

Allen Bentley

Title

Partner

Phone

(405) 627-5578

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401321600000",
    "number": "1114339827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9412 SW 32 ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73179",
            "telephone_number": "405-261-6858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 WINNIPEG DR",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "73099",
            "telephone_number": "405-261-6858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE MEDIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-29",
        "last_updated": "2014-05-29",
        "status": "A",
        "authorized_official_last_name": "BENTLEY",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "405-627-5578"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "OK",
            "license": "SAV 010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Missy Riddles LLC
• Karsyn Mitchell
• Michael Lance Mitchell, MSN, APRN, FNP-C
• Tyler Joshua Mitchum, DO
• Joseph Caleb Mitro, M.D.
• N. Catherine Montgomery, MS, RD, LD
• Courtney Brooke Moon
• Peggy Moore-Gardner, APRN
• Beverly Michelle Moore
• Brooke Moore, RBT

• Non-emergency Medical Transport (VAN) in Yukon, OK
• Providers in Yukon, OK by specialty
• Non-emergency Medical Transport (VAN) in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2014; 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.