Advanced Mobility of Bend, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

07-00000460 Issued in OR

Legal business name

ADVANCED MOBILITY OF BEND, LLC

Practice address

1045 NE 3Rd St
Bend, OR 97701-4526

Phone

(541) 382-6016

Fax

(541) 382-2987

NPI assigned

Jul 15, 2006

Reactivated

Jul 25, 2008

Last updated

Jul 25, 2008By 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

Lisa L. Cummins

Title

Owner

Phone

(541) 382-6016

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216944000000",
    "number": "1790701258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 NE 3RD ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014526",
            "telephone_number": "541-382-6016",
            "fax_number": "541-382-2987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 NE 3RD ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014526",
            "telephone_number": "541-382-6016",
            "fax_number": "541-382-2987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED MOBILITY OF BEND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2008-07-25",
        "deactivation_date": "2008-06-03",
        "reactivation_date": "2008-07-25",
        "status": "A",
        "authorized_official_last_name": "CUMMINS",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-382-6016"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OR",
            "license": "07-00000460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0208047",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278144",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Bend, OR
• Providers in Bend, OR by specialty
• Durable Medical Equipment & Medical Supplies in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2008; 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.