Southern Bus & Mobility, Inc

Primary specialty

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

Legal business name

SOUTHERN BUS & MOBILITY, INC

Practice address

12950 Koch LN
Breese, IL 62230-4220

Phone

(618) 526-4131

Fax

(618) 526-4585

NPI assigned

Apr 15, 2014

Last updated

Nov 11, 2024By 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

Mark Rakers

Title

Business Manager

Phone

(618) 526-4131

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731283200000",
    "number": "1811316011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12950 KOCH LN",
            "city": "BREESE",
            "state": "IL",
            "postal_code": "622304220",
            "telephone_number": "618-526-4131",
            "fax_number": "618-526-4585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12950 KOCH LN",
            "city": "BREESE",
            "state": "IL",
            "postal_code": "622304220",
            "telephone_number": "618-526-4131",
            "fax_number": "618-526-4585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN BUS & MOBILITY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-15",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A",
        "authorized_official_last_name": "RAKERS",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "618-526-4131"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Breese, IL
• Providers in Breese, IL by specialty
• Non-emergency Medical Transport (VAN) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.