Individual provider Active NPI

John C Mobley, M.D.

  • Surgery Physician
  • Greenville, OH
National Provider Identifier
1619059334
Registry record updated Oct 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35068284 Issued in OH
Practice address
404 Wagner Ave
Greenville, OH 45331-2537
Phone
(937) 548-8711
Fax
(937) 548-6724
NPI assigned
Oct 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 35068284 OH Primary

Addresses

Primary practice location

404 Wagner Ave
Greenville, OH 45331-2537

Mailing address

154 Bogle Office Park Dr Ste a
Somerset, KY 42503-2810
Phone (606) 676-0455

Other identifiers 1

IdentifierTypeStateIssuer
0137186MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111230000127 KY Practitioner - General Surgery 6305742545 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35068284OHMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Caldwell County Hospital, Inc. CurrentSince Sep 1, 2020 Accepting new patients
Caldwell County Hospital, Inc Current Accepting new patients
Caldwell County Hospital, Inc Surgery CurrentSince Sep 1, 2020 Accepting new patients
Lake Cumberland Physician Practices, LLC CurrentSince May 9, 2012 Accepting new patients
Lake Cumberland Physician Practices LLC CurrentSince May 9, 2012 Accepting new patients
Lake Cumberland Physician Practices, LLC Current Accepting new patients
Greenville Surgical Associates Surgery Past Accepting new patients

Locations

100 Medical Center Dr
Princeton, KY 42445
Phone (270) 365-0300

320 Micbeth Dr
Princeton, KY 42445
Phone (270) 365-0320

30 Tower Cir
Somerset, KY 42503
Phone (606) 451-8644

154 Bogle Office Park Dr
#A
Somerset, KY 42503
Phone (606) 425-4695

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GIDFCD
  • Direct secure messaging: john.mobley@caldmedassoc.eclinicaldirectplus.com

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Louisville School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caldwell County Hospital, Inc 25 clinicians

Practice addresses (Care Compare)

100 Medical Ctr Dr
Princeton, KY 42445-2430
Phone (270) 365-0308

Hospital & facility affiliations

  • Caldwell Medical Center Hospital, Princeton, KY, CCN 181322

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy34
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux37
Melanoma (skin cancer) excision12

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350950400000",
    "number": "1619059334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 BOGLE OFFICE PARK DR STE A",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425032810",
            "telephone_number": "606-676-0455",
            "fax_number": "606-425-4696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 WAGNER AVE",
            "city": "GREENVILLE",
            "state": "OH",
            "postal_code": "453312537",
            "telephone_number": "937-548-8711",
            "fax_number": "937-548-6724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOBLEY",
        "first_name": "JOHN",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2012-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35068284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0137186",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, OH

Sources for this page

Verify at the official NPI Registry.