Organization Active NPI

Maximum Mobility LLC

  • Customized Equipment (DME)
  • Sayre, PA
National Provider Identifier
1780749036
Registry record updated May 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
Legal business name
MAXIMUM MOBILITY LLC
Practice address
117 N Keystone Ave
Sayre, PA 18840
Phone
(570) 882-7436
Fax
(570) 882-7438
NPI assigned
Dec 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2018

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

Authorized official

Name
Mr. Jeffrey Gerard Klossner, OTR/L, ATP, RTS
Title
Owner
Phone
(570) 882-7436

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X Primary

Addresses

Primary practice location

117 N Keystone Ave
Sayre, PA 18840

Mailing address

117 N Keystone Ave
Sayre, PA 18840-1403
Phone (570) 882-7436

Other identifiers 2

IdentifierTypeStateIssuer
1024644040001MedicaidPA
02987039MedicaidNY

National Provider Directory

National Provider Directory

Locations

117 N Keystone Ave
Sayre, PA 18840
Phone (570) 882-7436

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527033600000",
    "number": "1780749036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 N KEYSTONE AVE",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401403",
            "telephone_number": "570-882-7436",
            "fax_number": "570-882-7438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 N KEYSTONE AVE",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "18840",
            "telephone_number": "570-882-7436",
            "fax_number": "570-882-7438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXIMUM MOBILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2018-05-23",
        "status": "A",
        "authorized_official_last_name": "KLOSSNER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "GERARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-882-7436",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OTR/L, ATP, RTS"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1024644040001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02987039",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sayre, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2018; 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.