Mobo Medical Spa LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

MOBO MEDICAL SPA LLC

Practice address

48 E Waterloo St
Canal Winchester, OH 43110-1138

Phone

(614) 768-6626

Fax

(614) 768-6626

NPI assigned

Jan 23, 2023

Organization subpart

No

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

Authorized official

Name

Margaret Fruth, APRN-CNPNPI 1831577469

Title

Managing Director

Phone

(740) 503-8413

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Margaret J Fruth, MS, RN

  • Acute Care Nurse Practitioner
  • Canal Winchester, OH
  • NPI 1831577469
  NPD Authorized official
• Lauren Riley Lund

  • Family Nurse Practitioner
  • Canal Winchester, OH
  • NPI 1942054739
  NPD

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674432000000",
    "number": "1235844333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 E WATERLOO ST",
            "city": "CANAL WINCHESTER",
            "state": "OH",
            "postal_code": "431101138",
            "telephone_number": "614-768-6626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 E WATERLOO ST",
            "city": "CANAL WINCHESTER",
            "state": "OH",
            "postal_code": "431101138",
            "telephone_number": "614-768-6626",
            "fax_number": "614-768-6626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBO MEDICAL SPA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A",
        "authorized_official_last_name": "FRUTH",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "740-503-8413",
        "authorized_official_credential": "APRN-CNP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eunice Mireku
• Camielle Janelle Mitchell, RN
• Dena Meranda Mitchell
• Mivaan Health Care Services LLC
• Ommari Baaliy Mkangara, LPN
• Joshua B Moles, PHARMD
• Nyasa N Moorehead
• Monice Denise Morgan
• Shlawn Morgan
• Joshua Ryan Morris, OD

• Nurse Practitioner in Canal Winchester, OH
• Providers in Canal Winchester, OH by specialty
• Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.