Momentum DME, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MOMENTUM DME, LLC

Practice address

121 S Broadway Ave Ste 606
Tyler, TX 75702-7281

Phone

(903) 224-5474

NPI assigned

Jul 31, 2020

Organization subpart

No

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

Authorized official

Name

Charles Long

Title

Owner

Phone

(903) 224-5474

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1596153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601942400000",
    "number": "1720698186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 S BROADWAY AVE STE 606",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757027281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 S BROADWAY AVE STE 606",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757027281",
            "telephone_number": "903-224-5474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOMENTUM DME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-31",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-224-5474"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachael Ekwevugbe Mofoye
• Ancelmo Mojarro, PTA
• Moleculab LLC
• Paul Molina, PT, DPT
• Rocio Molina
• Momentum ER Physicians PLLC
• Momentum Urgent Care, PLLC
• Jackie Mon, MD
• Rebecca L Monahan, RD, LD
• Lexi Leigh Monds, FNP-C

• Durable Medical Equipment & Medical Supplies in Tyler, TX
• Providers in Tyler, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; 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.