Southern Mobility and Medical, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

01024 Issued in NC

Legal business name

SOUTHERN MOBILITY AND MEDICAL, LLC

Practice address

1829 Capital Blvd Ste 103
Raleigh, NC 27604-2177

Phone

(800) 681-8831

Fax

(877) 611-3500

NPI assigned

Jun 27, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Scott H. Dannenberg

Title

President

Phone

(800) 681-8831

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1922035567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1829 CAPITAL BLVD STE 103",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276042177",
            "telephone_number": "800-681-8831",
            "fax_number": "877-611-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1829 CAPITAL BLVD STE 103",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276042177",
            "telephone_number": "800-681-8831",
            "fax_number": "877-611-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MOBILITY AND MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-27",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "DANNENBERG",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-681-8831",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NC",
            "license": "01024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010273773",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7704279",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Durable Medical Equipment & Medical Supplies in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.