NPIMap

Organization Active NPI

My Mobile MD Indiana LLC

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1912898321
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MY MOBILE MD INDIANA LLC
Practice address
429 E Vermont St Ste 110
Indianapolis, IN 46202-3685
Phone
(317) 559-0950
NPI assigned
Jul 14, 2025
Last updated
Jul 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Authorized official

Name
Steve Martin
Title
Ceo
Phone
(317) 670-6635

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

429 E Vermont St Ste 110
Indianapolis, IN 46202-3685

Mailing address

PO Box 586
Galloway, OH 43119-0586
Phone (765) 969-7841

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250804000306 IN Part B Supplier - Clinic/Group Practice 9830607605 Receives reassigned benefits from 28 practitioners
Practice locations: Indianapolis, IN

National Provider Directory

National Provider Directory

Locations

429 E Vermont St
Ste 110
Indianapolis, IN 46202
Phone (317) 536-2290

Practitioners & affiliated clinicians

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1752451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753056000000",
    "number": "1912898321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 586",
            "city": "GALLOWAY",
            "state": "OH",
            "postal_code": "431190586",
            "telephone_number": "765-969-7841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 E VERMONT ST STE 110",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462023685",
            "telephone_number": "317-559-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY MOBILE MD INDIANA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-14",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "317-670-6635"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.