Presidential Mobility

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PRESIDENTIAL MOBILITY

Practice address

1010 Rolling Hills Dr.
Ste. 110
Fayetteville, AR 72703

Phone

(479) 332-4990

Fax

(479) 332-4290

NPI assigned

Oct 11, 2005

Organization subpart

No

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

Authorized official

Name

Robin Grider, ATP

Title

DME Manager

Phone

(479) 332-4990

Specialties & licenses 4

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in AR

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": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734480000000",
    "number": "1710975008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10665",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727030046",
            "telephone_number": "479-332-4990",
            "fax_number": "479-332-4290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 ROLLING HILLS DR.",
            "address_2": "STE. 110",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "72703",
            "telephone_number": "479-332-4990",
            "fax_number": "479-332-4290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESIDENTIAL MOBILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-11",
        "last_updated": "2024-12-18",
        "certification_date": "2020-03-12",
        "status": "A",
        "authorized_official_last_name": "GRIDER",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "DME MANAGER",
        "authorized_official_telephone_number": "479-332-4990",
        "authorized_official_credential": "ATP"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171WH0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Contractor, Home Modifications",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141768784",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "48128",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130311772",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137085716",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Carolyn Jennifer Prescott
• Antonio Pressley Jr., ATC
• Zachary T Preston, DO
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• Heather Pribislavski, CRNA
• Victor Pribislavski, CRNA

• Durable Medical Equipment & Medical Supplies in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Durable Medical Equipment & Medical Supplies in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; 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.