Community Care Mobile Clinic LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

COMMUNITY CARE MOBILE CLINIC LLC

Practice address

169 Packing House Rd
Americus, GA 31709-7932

Phone

(229) 410-9174

NPI assigned

Jan 4, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Deborah Tymes Rhodes, DNP, FNP-BCNPI 1609077908

Title

Owner

Phone

(229) 410-9174

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Deborah Tymes Rhodes, DNP, FNP-BC

  • Family Nurse Practitioner
  • Americus, GA
  • NPI 1609077908
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1704326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736812800000",
    "number": "1871363564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1636",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317091636",
            "telephone_number": "229-410-9174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 PACKING HOUSE RD",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317097932",
            "telephone_number": "229-410-9174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE MOBILE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-04",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A",
        "authorized_official_last_name": "RHODES",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "TYMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-410-9174",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DNP, FNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Service Clinic/Center in Americus, GA
• Providers in Americus, GA by specialty
• Health Service Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.