Mobility Plus Homecare, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

221831 Issued in KY

Legal business name

MOBILITY PLUS HOMECARE, INC.

Practice address

200 Sycamore St
Suite 136
Elizabethtown, KY 42701-2469

Phone

(270) 360-0486

Fax

(270) 360-1841

NPI assigned

Mar 5, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Jeffrey Allan Averitt

Title

President

Phone

(270) 360-0486

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450396800000",
    "number": "1487783676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SYCAMORE ST",
            "address_2": "SUITE 136",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012469",
            "telephone_number": "270-360-0486",
            "fax_number": "270-360-1841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SYCAMORE ST",
            "address_2": "SUITE 136",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012469",
            "telephone_number": "270-360-0486",
            "fax_number": "270-360-1841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILITY PLUS HOMECARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2015-12-18",
        "status": "A",
        "authorized_official_last_name": "AVERITT",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "ALLAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "270-360-0486",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "KY",
            "license": "221831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "000000201522",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT HEALTH PLAN",
            "identifier": "1129616",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "247572000",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90001686",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2015; 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.