Individual provider Active NPI

Kathleen Mobley, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Brooksville, FL
National Provider Identifier
1174546717
Registry record updated May 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
ME51280 Issued in FL
Practice address
11375 Cortez Blvd
Brooksville, FL 34613-5409
Phone
(305) 665-4614
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X ME51280 FL Primary

Addresses

Primary practice location

11375 Cortez Blvd
Brooksville, FL 34613-5409

Mailing address

PO Box 60100
Charleston, SC 29419-0100
Phone (800) 664-3939

Other identifiers 2

IdentifierTypeStateIssuer
04287OtherFLBLUE CROSS BLUE SHIELD
036185200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051006000233 FL Practitioner - Pathology 2668407933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Medical College of Georgia School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Regional Laboratories Pathology Services, LLCGroup PAC ID 9133244346, 132 clinicians

Practice addresses (Care Compare)

11375 Cortez Blvd
Brooksville, FL 34613-5409
Phone (352) 597-7083

5301 S Congress Ave
Atlantis, FL 33462-1149
Phone (561) 548-3639

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
West Coast Pathology of Florida, PA Anatomic Pathology & Clinical Pathology Current Accepting new patients
Integrated Regional Laboratories Pathology Services, LLC Anatomic Pathology & Clinical Pathology CurrentSince Nov 1, 2014 Accepting new patients

Locations

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

5301 S Congress Ave
Lantana, FL 33462
Phone (561) 548-3549

11375 Cortez Blvd
Weeki Wachee, FL 34613
Phone (352) 596-4209

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335916800000",
    "number": "1174546717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60100",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294190100",
            "telephone_number": "800-664-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11375 CORTEZ BLVD",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346135409",
            "telephone_number": "305-665-4614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOBLEY",
        "first_name": "KATHLEEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2012-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME51280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "04287",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036185200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooksville, FL

Sources for this page

Verify at the official NPI Registry.