NPIMap

Organization Active NPI

Relatyv Mobile Medical LLC

  • Other Specialist/Technologist
  • Verona, KY
National Provider Identifier
1154119261
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other Specialist/TechnologistTaxonomy code 246Z00000X
Legal business name
RELATYV MOBILE MEDICAL LLC
Practice address
15949 Lebanon Crittenden Rd
Verona, KY 41092-8224
Phone
(866) 953-2175
Fax
(877) 285-0477
NPI assigned
Apr 28, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Authorized official

Name
Janice A Compton
Title
Contracting
Phone
(830) 832-9703

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other Specialist/TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 246Z00000X Primary

Addresses

Primary practice location

15949 Lebanon Crittenden Rd
Verona, KY 41092-8224

Mailing address

4140 E Baseline Rd Ste 101
Mesa, AZ 85206-4413
Phone (866) 953-2175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250618000489 KY Part B Supplier - Clinic/Group Practice 4082130109 Receives reassigned benefits from 1 practitioner
Practice locations: Verona, KY

National Provider Directory

National Provider Directory
Tax ID family
Relatyv Mobile Medical LLC40 organizations share this tax ID, including this one

Other organizations with this tax ID 39

Organizations that report the same tax identification number in the National Provider Directory.

View all 39

Locations

4140 E Baseline Rd
Ste 101
Mesa, AZ 85206
Phone (480) 482-1838

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1745798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745884800000",
    "number": "1154119261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 E BASELINE RD STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064413",
            "telephone_number": "866-953-2175",
            "fax_number": "877-285-0477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15949 LEBANON CRITTENDEN RD",
            "city": "VERONA",
            "state": "KY",
            "postal_code": "410928224",
            "telephone_number": "866-953-2175",
            "fax_number": "877-285-0477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RELATYV MOBILE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-28",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A",
        "authorized_official_last_name": "COMPTON",
        "authorized_official_first_name": "JANICE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CONTRACTING",
        "authorized_official_telephone_number": "830-832-9703"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Verona, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.