NPIMap

Organization Active NPI

Mobile Med LLC

  • Oxygen Equipment & Supplies (DME)
  • Rome, GA
National Provider Identifier
1528083318
Registry record updated Apr 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
Legal business name
MOBILE MED LLC
Practice address
14 John Davenport Dr NW Ste 100
Rome, GA 30165-4600
Phone
(706) 235-0509
NPI assigned
Jul 13, 2006
Organization subpart
Yes
Parent organization
MED EMPORIUM, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 17, 2017

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

Authorized official

Name
Mrs. Donna Groce
Title
Manager
Phone
(864) 675-1330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oxygen Equipment & Supplies (DME) 332BX2000X Primary

Addresses

Primary practice location

14 John Davenport Dr NW Ste 100
Rome, GA 30165-4600

Mailing address

1247 S Pleasantburg Dr
Greenville, SC 29605-1344
Phone (864) 675-1330

Other identifiers 1

IdentifierTypeStateIssuer
511431717AMedicaidGA

Other names 1

  • ROME RESPIRATORY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930019554 GA DME Supplier - Medical Supply CompanyDME Supplier - Oxygen & Equipment 5092925818 Practice locations: Rome, GA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Rome Respiratory14 John Davenport Dr NW, Rome, GA 30165-4600(706) 235-0509 Automatic Ext Defibrillator (AEDS) and/or Supplies|Commodes, Urinals, Bedpans|Continuous Passive Motion (CPM) Devices|Gastric Suction Pumps|Heat & Cold Applications|Hospital Beds (Electric)|Hospital Beds (Manual)|Negative Pressure Wound Therapy Pumps/Supplies|Neuromuscular Elect Stimulators (NMES)/… Does not accept assignmentParticipating since Dec 27, 2004

National Provider Directory

National Provider Directory
Tax ID family
Mobile Med LLC6 organizations share this tax ID, including this one
Part of
Medemporium LLC

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

14 John Davenport Dr NW
Ste 100
Rome, GA 30165
Phone (706) 235-0509

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492387200000",
    "number": "1528083318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1247 S PLEASANTBURG DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296051344",
            "telephone_number": "864-675-1330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 JOHN DAVENPORT DR NW STE 100",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301654600",
            "telephone_number": "706-235-0509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE MED LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MED EMPORIUM, LLC",
        "enumeration_date": "2006-07-13",
        "last_updated": "2017-04-17",
        "status": "A",
        "authorized_official_last_name": "GROCE",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "864-675-1330",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "511431717A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ROME RESPIRATORY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rome, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.