Minnesota Mobile Exams LLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

MINNESOTA MOBILE EXAMS LLC

Practice address

401 16TH Ave NW Ste 106
Rochester, MN 55901-1853

Phone

(507) 258-4680

Fax

(507) 258-4600

NPI assigned

May 20, 2021

Last updated

Dec 14, 2022By 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

Gene Truman Cox, CPN

Title

Director

Phone

(507) 258-4680

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255906426. Details of each certification follow.

• CCN 24X0009382 Portable X-ray supplier · Active · Name & address match · Details

Portable X-ray supplier certification: CCN 24X0009382

Legal name

MINNESOTA MOBILE EXAMS LLC

Certification status

Active

Provider type (POS)

Portable X-ray supplier

Participating since

Feb 13, 2024

Last certification

Feb 13, 2024

Ownership / control type

Individual

Facility address

401 16TH Avenue NW Ste 106
Rochester, MN 55901

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael H Broderdorf, MD

  • Emergency Medicine Physician
  • Rochester, MN
  • NPI 1346209301
  Medicare reassignment NPD

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

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670976000000",
    "number": "1255906426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 16TH AVE NW STE 106",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559011853",
            "telephone_number": "507-258-4680",
            "fax_number": "507-258-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 16TH AVE NW STE 106",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559011853",
            "telephone_number": "507-258-4680",
            "fax_number": "507-258-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA MOBILE EXAMS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-20",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A",
        "authorized_official_last_name": "COX",
        "authorized_official_first_name": "GENE",
        "authorized_official_middle_name": "TRUMAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "507-258-4680",
        "authorized_official_credential": "CPN"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RADIOLOGY CONTROL, X-RAY UNIT",
            "identifier": "55-10900",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "24D2214580",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Urgent Care Clinic/Center in Rochester, MN
• Providers in Rochester, MN by specialty
• Urgent Care Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.