NPIMap

Organization Active NPI

Freedom Mobility LLC

  • Customized Equipment (DME)
  • Avon, IN
National Provider Identifier
1144355199
Registry record updated Sep 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
License
69000088A Issued in IN
Legal business name
FREEDOM MOBILITY LLC
Practice address
222 Shelton Drive
Avon, IN 46123
Phone
(317) 209-8004
Fax
(317) 272-1966
NPI assigned
Feb 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2007

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

Authorized official

Name
Pauline R McCanless, OWNER
Title
Owner
Phone
(317) 209-8004

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X 69000088A IN Primary

Addresses

Primary practice location

222 Shelton Drive
Avon, IN 46123

Mailing address

222 Shelton Drive
Avon, IN 46123
Phone (317) 209-8004

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190678400000",
    "number": "1144355199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 SHELTON DRIVE",
            "city": "AVON",
            "state": "IN",
            "postal_code": "46123",
            "telephone_number": "317-209-8004",
            "fax_number": "317-272-1966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 SHELTON DRIVE",
            "city": "AVON",
            "state": "IN",
            "postal_code": "46123",
            "telephone_number": "317-209-8004",
            "fax_number": "317-272-1966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEDOM MOBILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-09-25",
        "status": "A",
        "authorized_official_last_name": "MCCANLESS",
        "authorized_official_first_name": "PAULINE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-209-8004",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "IN",
            "license": "69000088A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; 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.