Mobile Visions Ins

Primary specialty

Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X

Legal business name

MOBILE VISIONS INS

Practice address

7820 N Point Blvd
Suite 101
Winston Salem, NC 27106-3299

Phone

(336) 245-0647

Fax

(336) 245-0649

NPI assigned

Sep 12, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Ken Burkel

Title

Officer

Phone

(336) 462-4717

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• QUALITY MOBILE XRAY EAST Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407950199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7820 N POINT BLVD",
            "address_2": "SUITE 101",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063299",
            "telephone_number": "336-245-0647",
            "fax_number": "336-245-0649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7820 N POINT BLVD",
            "address_2": "SUITE 101",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063299",
            "telephone_number": "336-245-0647",
            "fax_number": "336-245-0649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE VISIONS INS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURKEL",
        "authorized_official_first_name": "KEN",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "336-462-4717",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD ID NUMB",
            "identifier": "P00241101",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409806",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "QUALITY MOBILE XRAY EAST",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Douglas Wayne Miyazaki, M.D.
• Gaye Mize
• Billie Dahl Mizel, LPC
• Amirhossein Moaddab, M.D.
• Mobile Visions Inc
• Emily Lynn Mobley, LAT, ATC
• Kesean Legrant Mobley, LCSWA
• Jonathan Christian Mochnick, D.M.D.
• Linda Thomas Mock, MA CCC/A
• Monique Ladosca Mock, CNA, MED TECH

• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in North Carolina

• 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.
• 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.