State Express Mobility LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

STATE EXPRESS MOBILITY LLC

Practice address

5401 94TH Ave N Unit 104
Brooklyn Park, MN 55443-5501

Phone

(763) 496-4189

NPI assigned

Apr 2, 2025

Last updated

Apr 2, 2025By 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

Samira Tala

Title

Manager/Driver

Phone

(763) 334-8981

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1743552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743552000000",
    "number": "1770387532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 94TH AVE N UNIT 104",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554435501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 94TH AVE N UNIT 104",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554435501",
            "telephone_number": "763-496-4189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE EXPRESS MOBILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-02",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A",
        "authorized_official_last_name": "TALA",
        "authorized_official_first_name": "SAMIRA",
        "authorized_official_title_or_position": "MANAGER/DRIVER",
        "authorized_official_telephone_number": "763-334-8981"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Brooklyn Park, MN
• Providers in Brooklyn Park, MN by specialty
• Non-emergency Medical Transport (VAN) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; 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.