Individual provider Active NPI

Daniel T Mamo

  • Driver
  • Columbus, OH
National Provider Identifier
1386360253
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
202220301088 Issued in OH
Practice address
1252 Westphal Ave
Columbus, OH 43227-2041
Phone
(614) 806-0633
NPI assigned
Oct 12, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X 202220301088 OH Primary

Addresses

Primary practice location

1252 Westphal Ave
Columbus, OH 43227-2041

Mailing address

1252 Westphal Ave
Columbus, OH 43227-2041
Phone (614) 806-0633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
202220301088OHMDDriver

Practice roles

OrganizationSpecialtyStatusNew patients
Secured Medical Logistics LLC CurrentSince Oct 16, 2022 Accepting new patients
B&D Medical Transportation LLC Driver CurrentSince Oct 23, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1386360253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1252 WESTPHAL AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432272041",
            "telephone_number": "614-806-0633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1252 WESTPHAL AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432272041",
            "telephone_number": "614-806-0633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMO",
        "first_name": "DANIEL",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-12",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "OH",
            "license": "202220301088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; 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.