Custom Mobility Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

62 CERTIFICATE 8809 Issued in FL

Legal business name

CUSTOM MOBILITY INC

Practice address

7199 Bryan Dairy Road
Largo, FL 33777-1502

Phone

(727) 539-8119

Fax

(727) 539-6372

NPI assigned

Nov 15, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Bruce D Bayes

Title

President Ceo

Phone

(727) 539-8119

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

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

Locations

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609858752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7199 BRYAN DAIRY ROAD",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337771502",
            "telephone_number": "727-539-8119",
            "fax_number": "727-539-6372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7199 BRYAN DAIRY ROAD",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337771502",
            "telephone_number": "727-539-8119",
            "fax_number": "727-539-6372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM MOBILITY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAYES",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "727-539-8119",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "62 CERTIFICATE 8809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Largo, FL
• Durable Medical Equipment & Medical Supplies in Florida

• 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.
• 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.