Jeremiah Mobley, MBID, ATC

Primary specialty

Hearing Instrument SpecialistTaxonomy code 237700000X

License

HAA000150 Issued in GA

Practice address

536 Newnan St
Carrollton, GA 30117-3344

Phone

(770) 577-2360

NPI assigned

May 20, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1463702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1336596261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "536 NEWNAN ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173344",
            "telephone_number": "770-577-2360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 NEWNAN ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173344",
            "telephone_number": "770-577-2360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7421 Douglas Blvd Ste F",
            "address_purpose": "LOCATION",
            "city": "Douglasville",
            "state": "GA",
            "postal_code": "301351564",
            "country_code": "US",
            "telephone_number": "770-557-2360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOBLEY",
        "first_name": "JEREMIAH",
        "credential": "MBID, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-20",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT001625",
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "GA",
            "license": "HAA000150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Hearing Instrument Specialist in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Hearing Instrument Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.