NPIMap

Organization Active NPI

Mobile Med Inc

  • Oxygen Equipment & Supplies (DME)
  • Louisville, KY
National Provider Identifier
1285659151
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
Legal business name
MOBILE MED INC
Practice address
114 S Clifton Ave
Louisville, KY 40206-2406
Phone
(502) 896-8335
NPI assigned
Jul 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Gary N Beson II
Title
President
Phone
(843) 285-7903

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oxygen Equipment & Supplies (DME) 332BX2000X Primary

Addresses

Primary practice location

114 S Clifton Ave
Louisville, KY 40206-2406

Mailing address

200 West 5TH Street North
Summerville, SC 29483
Phone (843) 285-7903

Other identifiers 3

IdentifierTypeStateIssuer
50009464MedicaidKY
90011461MedicaidKY
370765OtherKYANTHEM BCBS

Other names 1

  • Breathe Medical Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mobile Med LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

114 S Clifton Ave
Louisville, KY 40206
Phone (502) 896-8335

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285659151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 WEST 5TH STREET NORTH",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "29483",
            "telephone_number": "843-285-7903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 S CLIFTON AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402062406",
            "telephone_number": "502-896-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE MED INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BESON",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-285-7903",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50009464",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90011461",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "370765",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Breathe Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.