NPIMap

Organization Active NPI

Freedom Mobility Center, Inc.

  • Customized Equipment (DME)
  • Columbia, SC
National Provider Identifier
1710408836
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
Legal business name
FREEDOM MOBILITY CENTER, INC.
Practice address
224 Oneil CT Ste 23
Columbia, SC 29223-7649
Phone
(803) 807-2999
Fax
(803) 708-1843
NPI assigned
Jun 28, 2017
Last updated
Mar 3, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
FREEDOM MOBILITY CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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

Authorized official

Name
John Gilbert Cotham
Title
Ceo
Phone
(704) 658-0817

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Customized Equipment (DME) 332BC3200X Primary

Addresses

Primary practice location

224 Oneil CT Ste 23
Columbia, SC 29223-7649

Mailing address

110 Talbert Pointe Dr
Mooresville, NC 28117-4377
Phone (704) 658-0817

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180621001664 SC DME Supplier - Medical Supply Company 5698989440 Practice locations: Columbia, SC

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
Freedom Mobility Center Inc5 organizations share this tax ID, including this one
Part of
Freedom Mobility Center Inc

Other organizations with this tax ID 4

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

Locations

224 Oneil Ct
Ste 23
Columbia, SC 29223
Phone (803) 807-2999

NPI Registry JSON

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

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614729600000",
    "number": "1710408836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 TALBERT POINTE DR",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281174377",
            "telephone_number": "704-658-0817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 ONEIL CT STE 23",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292237649",
            "telephone_number": "803-807-2999",
            "fax_number": "803-708-1843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEDOM MOBILITY CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FREEDOM MOBILITY CENTER, INC.",
        "enumeration_date": "2017-06-28",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A",
        "authorized_official_last_name": "COTHAM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "GILBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-658-0817"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.