M.E.D. Supported Living, LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

M.E.D. SUPPORTED LIVING, LLC

Doing business as

M.B.D. Trusted Transport

Practice address

675 Alpha Dr Ste G
Suite# G
Highland HTS, OH 44143-2139

Phone

(216) 220-1885

Fax

(440) 815-2184

NPI assigned

Oct 28, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Derek R Brantley

Title

C.E.O.

Phone

(216) 544-3946

Specialties & licenses 2

Addresses

Other names 1

• M.B.D. Trusted Transport Doing business as

Locations

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

{
    "created_epoch": "1414454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725494400000",
    "number": "1396140760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1797 KAREN DR",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441172237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 ALPHA DR STE G",
            "address_2": "SUITE# G",
            "city": "HIGHLAND HTS",
            "state": "OH",
            "postal_code": "441432139",
            "telephone_number": "216-220-1885",
            "fax_number": "440-815-2184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M.E.D. SUPPORTED LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-28",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A",
        "authorized_official_last_name": "BRANTLEY",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "216-544-3946",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "M.B.D. Trusted Transport",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Non-emergency Medical Transport (VAN) in Highland HTS, OH
• Providers in Highland HTS, OH by specialty
• Non-emergency Medical Transport (VAN) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; 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.