NPIMap

Organization Active NPI

Custom Healthcare, LLC

Doing business as Phoenix Rehab & Mobility

  • Customized Equipment (DME)
  • Belton, SC
National Provider Identifier
1326511643
Registry record updated Jan 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
Legal business name
CUSTOM HEALTHCARE, LLC
Doing business as
Phoenix Rehab & Mobility
Practice address
110 Palmetto Pkwy
Belton, SC 29627-2126
Phone
(864) 392-1750
Fax
(706) 740-0787
NPI assigned
Jan 9, 2019
Last updated
Jan 9, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2019

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

Authorized official

Name
James Rogers
Title
Ceo
Phone
(423) 697-0057

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Customized Equipment (DME) 332BC3200X Primary
Oxygen Equipment & Supplies (DME) 332BX2000X

Addresses

Primary practice location

110 Palmetto Pkwy
Belton, SC 29627-2126

Mailing address

3700 Brainerd Rd Ste 134
Chattanooga, TN 37411-3603
Phone (423) 697-0057

Other names 1

  • Phoenix Rehab & Mobility Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Custom Healthcare12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

110 Palmetto Pkwy
Belton, SC 29627
Phone (864) 392-1750

3700 Brainerd Rd
Ste 134
Chattanooga, TN 37411
Phone (423) 697-0057

NPI Registry JSON

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

{
    "created_epoch": "1546992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546992000000",
    "number": "1326511643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 BRAINERD RD STE 134",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374113603",
            "telephone_number": "423-697-0057",
            "fax_number": "423-648-9366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 PALMETTO PKWY",
            "city": "BELTON",
            "state": "SC",
            "postal_code": "296272126",
            "telephone_number": "864-392-1750",
            "fax_number": "706-740-0787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-09",
        "last_updated": "2019-01-09",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "423-697-0057"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenix Rehab & Mobility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Belton, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; 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.