Mobileray Inc

Primary specialty

Radiologic TechnologistTaxonomy code 247100000X

License

285746 Issued in NC

Legal business name

MOBILERAY INC

Practice address

1886 Gola Dr
Fayetteville, NC 28301-0522

Phone

(910) 488-7752

Fax

(910) 221-7037

NPI assigned

Feb 27, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Emery Earle Gibbs, RT-R

Title

Cheif of Operations

Phone

(910) 488-7752

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427184845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1886 GOLA DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283010522",
            "telephone_number": "910-488-7752",
            "fax_number": "910-221-7037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1886 GOLA DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283010522",
            "telephone_number": "910-488-7752",
            "fax_number": "910-221-7037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILERAY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GIBBS",
        "authorized_official_first_name": "EMERY",
        "authorized_official_middle_name": "EARLE",
        "authorized_official_title_or_position": "CHEIF OF OPERATIONS",
        "authorized_official_telephone_number": "910-488-7752",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RT-R"
    },
    "taxonomies": [
        {
            "code": "247100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiologic Technologist",
            "state": "NC",
            "license": "285746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS AND BLU",
            "identifier": "220NMEDCAREPRO",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUE SHIELD OF",
            "identifier": "0181Y",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409818",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Radiologic Technologist in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Radiologic Technologist 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.