Organization Active NPI

NP Mobile Medical Group, LLC

  • Family Nurse Practitioner
  • West Palm Beach, FL
National Provider Identifier
1154780450
Registry record updated Mar 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9214512 Issued in FL
Legal business name
NP MOBILE MEDICAL GROUP, LLC
Practice address
11580 Mellow CT
West Palm Beach, FL 33411-9125
Phone
(561) 267-3345
Fax
(888) 939-4244
NPI assigned
Feb 15, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2019

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

Authorized official

Name
Michelle Bowman, ARNP
Title
President
Phone
(561) 719-2223

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X ARNP9214512 FL Primary

Addresses

Primary practice location

11580 Mellow CT
West Palm Beach, FL 33411-9125

Mailing address

11580 Mellow CT
West Palm Beach, FL 33411-9125
Phone (561) 267-3345

Other identifiers 2

IdentifierTypeStateIssuer
7511795OtherCIGNA PROVIDER NUMBER
YOM6JOtherBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160512000944 FL Part B Supplier - Clinic/Group Practice 5496044570 Receives reassigned benefits from 1 practitioner
Practice locations: West Palm Beach, FL

National Provider Directory

National Provider Directory

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": "1455494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551398400000",
    "number": "1154780450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11580 MELLOW CT",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334119125",
            "telephone_number": "561-267-3345",
            "fax_number": "888-939-4244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11580 MELLOW CT",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334119125",
            "telephone_number": "561-267-3345",
            "fax_number": "888-939-4244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NP MOBILE MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-15",
        "last_updated": "2019-03-01",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-719-2223",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9214512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER NUMBER",
            "identifier": "7511795",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "YOM6J",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2019; 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.