NPIMap

Organization Active NPI

Sopers Mobility AIDS LLC

  • Durable Medical Equipment & Medical Supplies
  • Dalton Gardens, ID
National Provider Identifier
1669440392
Registry record updated Feb 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
59 Issued in ID
Legal business name
SOPERS MOBILITY AIDS LLC
Practice address
7392 N Government Way
Dalton Gardens, ID 83815-8762
Phone
(208) 772-6474
Fax
(208) 772-6797
NPI assigned
Mar 9, 2006
Last updated
Feb 23, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2015

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

Authorized official

Name
Mrs. Geneva J Soper
Title
Owner Manager
Phone
(208) 772-6474

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 59 ID Primary

Addresses

Primary practice location

7392 N Government Way
Dalton Gardens, ID 83815-8762

Mailing address

PO Box 2344
Hayden, ID 83835
Phone (208) 772-6474

Other identifiers 5

IdentifierTypeStateIssuer
8F728OtherIDBLUE CROSS OF IDAHO
000010137053OtherIDREGENCE BLUE SHIELD
805521400MedicaidID
805503900MedicaidID
9054511MedicaidWA

National Provider Directory

National Provider Directory

Locations

7392 N Government Way
Dalton Gardens, ID 83815
Phone (208) 772-6474

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424649600000",
    "number": "1669440392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2344",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "83835",
            "telephone_number": "208-772-6474",
            "fax_number": "208-772-6797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7392 N GOVERNMENT WAY",
            "city": "DALTON GARDENS",
            "state": "ID",
            "postal_code": "838158762",
            "telephone_number": "208-772-6474",
            "fax_number": "208-772-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOPERS MOBILITY AIDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-09",
        "last_updated": "2015-02-23",
        "status": "A",
        "authorized_official_last_name": "SOPER",
        "authorized_official_first_name": "GENEVA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER MANAGER",
        "authorized_official_telephone_number": "208-772-6474",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "ID",
            "license": "59",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "8F728",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "000010137053",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805521400",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805503900",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9054511",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton Gardens, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.