Organization Active NPI

Mobile Medical Care

  • Adult Health Nurse Practitioner
  • Columbia, TN
National Provider Identifier
1396169587
Registry record updated Feb 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
Legal business name
MOBILE MEDICAL CARE
Practice address
2504 Cayer LN
Suite C
Columbia, TN 38401-7383
Phone
(615) 624-1613
NPI assigned
Feb 10, 2014
Last updated
Feb 10, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2014

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

Authorized official

Name
Mekonnen S Kidane, DNP
Title
Owner/Provider
Phone
(615) 624-1613

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2200X Primary

Addresses

Primary practice location

2504 Cayer LN
Suite C
Columbia, TN 38401-7383

Mailing address

PO Box 210929
Nashville, TN 37221-0929
Phone (615) 624-1613

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1391990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391990400000",
    "number": "1396169587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 210929",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372210929",
            "telephone_number": "615-624-1613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 CAYER LN",
            "address_2": "SUITE C",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384017383",
            "telephone_number": "615-624-1613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE MEDICAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-10",
        "last_updated": "2014-02-10",
        "status": "A",
        "authorized_official_last_name": "KIDANE",
        "authorized_official_first_name": "MEKONNEN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "615-624-1613",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2014; 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.