Independent Mobility Plus, Inc.

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

INDEPENDENT MOBILITY PLUS, INC.

Practice address

450 N Military Ave
Suite #7
Green Bay, WI 54303-4570

Phone

(920) 965-6000

Fax

(920) 491-0527

NPI assigned

May 20, 2006

Organization subpart

No

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

Authorized official

Name

Evan Parker

Title

Owner / President

Phone

(920) 965-6000

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821042136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 N MILITARY AVE",
            "address_2": "SUITE #7",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543034570",
            "telephone_number": "920-965-6000",
            "fax_number": "920-491-0527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 N MILITARY AVE",
            "address_2": "SUITE #7",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543034570",
            "telephone_number": "920-965-6000",
            "fax_number": "920-491-0527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT MOBILITY PLUS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "EVAN",
        "authorized_official_title_or_position": "OWNER / PRESIDENT",
        "authorized_official_telephone_number": "920-965-6000"
    },
    "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": "41750600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Customized Equipment (DME) in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Customized Equipment (DME) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.