Kingdom Mobile Lab Services LLC

Primary specialty

Phlebotomy TechnicianTaxonomy code 246RP1900X

Legal business name

KINGDOM MOBILE LAB SERVICES LLC

Doing business as

Kingdom Mobile Lab Services LLC

Practice address

7674 Mountain Creek Way
Douglasville, GA 30134-3783

Phone

(678) 368-2745

Fax

(678) 306-5637

NPI assigned

Sep 9, 2021

Last updated

Sep 9, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Keesha M McCloudNPI 1962033563

Title

Owner

Phone

(678) 368-2745

Specialties & licenses 1

Addresses

Other names 1

• Kingdom Mobile Lab Services LLC Doing business as

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Keesha McCloud

  • Homemaker
  • Atlanta, GA
  • NPI 1962033563
  NPD (past) Authorized official

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

{
    "created_epoch": "1631145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631145600000",
    "number": "1700555018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7674 MOUNTAIN CREEK WAY",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301343783",
            "telephone_number": "678-368-2745",
            "fax_number": "678-306-5637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7674 MOUNTAIN CREEK WAY",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301343783",
            "telephone_number": "678-368-2745",
            "fax_number": "678-306-5637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGDOM MOBILE LAB SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-09",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A",
        "authorized_official_last_name": "MCCLOUD",
        "authorized_official_first_name": "KEESHA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-368-2745"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.kalixhealth.com/",
            "affiliation": "N",
            "endpointDescription": "Hippa Compliant EMR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7674 Mountain Creek Way",
            "city": "Douglasville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301343783",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Kingdom Mobile Lab Services LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kindred Hearts Care Providers, LLC
• Lonnie King III
• Marshaleen N. Henriques King, MD
• Valarie Evans King, FNP
• Kingdom Cardiovascular Care and Wellness Center, LLC (Comprehensive Cardiovascular Care and Wellness)
• Richard W. Kinsey, D.M.D.
• Jasmine Darniece Kirkland, FNP
• Mekayla Kirt
• Martha Kitchens, M.A.
• Alleyah Knight

• Phlebotomy Technician in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Phlebotomy Technician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; 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.