NPIMap

Organization Active NPI

Mobile Medical, LLC

  • Family Medicine Physician
  • Wichita, KS
National Provider Identifier
1366727463
Registry record updated Sep 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MOBILE MEDICAL, LLC
Practice address
345 N Riverview St Ste 500
Wichita, KS 67203-4265
Phone
(316) 616-1055
Fax
(855) 633-0585
NPI assigned
Oct 20, 2011
Last updated
Sep 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2025

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

Authorized official

Name
Brent Sanders
Title
Ceo
Phone
(316) 616-1055

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X KS

Addresses

Primary practice location

345 N Riverview St Ste 500
Wichita, KS 67203-4265

Mailing address

345 N Riverview St Ste 412
Wichita, KS 67203-4202
Phone (551) 295-8223

Other practice location 1

117 S Lexington St Ste 100
Harrisonville, MO 64701-2444
Phone (316) 616-1055

Other practice location 2

801 E Douglas Ave Fl 2nd
Wichita, KS 67202-3515
Phone (551) 295-8223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220203002512 MO Part B Supplier - Clinic/Group Practice 9335316066 Receives reassigned benefits from 3 practitioners
Practice locations: Harrisonville, MO

National Provider Directory

National Provider Directory

Locations

345 N Riverview St
Ste 500
Wichita, KS 67203
Phone (316) 616-1055

530 N Ridge Rd
Wichita, KS 67212
Phone (316) 201-4063

530 N Ridge Rd
Ste B
Wichita, KS 67212
Phone (316) 616-1055

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757721600000",
    "number": "1366727463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 N RIVERVIEW ST STE 412",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672034202",
            "telephone_number": "551-295-8223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 N RIVERVIEW ST STE 500",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672034265",
            "telephone_number": "316-616-1055",
            "fax_number": "855-633-0585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 S Lexington St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Harrisonville",
            "state": "MO",
            "postal_code": "647012444",
            "country_code": "US",
            "telephone_number": "316-616-1055",
            "fax_number": "855-633-0585",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 E Douglas Ave Fl 2nd",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672023515",
            "country_code": "US",
            "telephone_number": "551-295-8223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MOBILE MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-20",
        "last_updated": "2025-09-13",
        "certification_date": "2025-09-13",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "316-616-1055"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.