Mobile Physicians Group LLC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

07001158A Issued in IN

Legal business name

MOBILE PHYSICIANS GROUP LLC

Practice address

2308 Roosevelt Rd
Valparaiso, IN 46383-2773

Phone

(219) 464-9588

Fax

(219) 462-4470

NPI assigned

Apr 4, 2016

Last updated

Mar 7, 2023By 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

Dr. Timothy Fitzgerald, D.P.M.

Title

Owner

Phone

(219) 464-9588

Specialties & licenses 1

Addresses

Other identifiers 5

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

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1144683301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 SILHAVY RD",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463834452",
            "telephone_number": "219-464-9588",
            "fax_number": "219-462-4470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2308 ROOSEVELT RD",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832773",
            "telephone_number": "219-464-9588",
            "fax_number": "219-462-4470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE PHYSICIANS GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-04",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "219-464-9588",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "IN",
            "license": "07001158A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1265759054",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSR",
            "identifier": "07001158B",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "07001158A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201166760A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01563138",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jena Shea Mitchell
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• Bruce Moberley, D.O.
• Mobile Mental Wellness, LLC
• Mobile Wellness Incorporated
• Kamala B Modur, MD
• Elizabeth Victoria Moerman, FNP
• Hermann Brice Mofang
• Melissa Moisant

• Podiatrist in Valparaiso, IN
• Providers in Valparaiso, IN by specialty
• Podiatrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.