Amerisouth Mobility, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

K931128 Issued in GA

Legal business name

AMERISOUTH MOBILITY, LLC

Practice address

26 Executive Park W
Suite 2603
Atlanta, GA 30329-2202

Phone

(404) 321-5500

Fax

(404) 321-5530

NPI assigned

Jul 1, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jason Allen Dannenberg

Title

Managing Member

Phone

(404) 321-5500

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396742532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 EXECUTIVE PARK W",
            "address_2": "SUITE 2603",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292202",
            "telephone_number": "404-321-5500",
            "fax_number": "404-321-5530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 EXECUTIVE PARK W",
            "address_2": "SUITE 2603",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292202",
            "telephone_number": "404-321-5500",
            "fax_number": "404-321-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERISOUTH MOBILITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DANNENBERG",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "404-321-5500"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": "K931128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00849142A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.