NPIMap

Organization Active NPI

My Mobile MD Ohio LLC

  • Family Medicine Physician
  • Galloway, OH
National Provider Identifier
1992372031
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MY MOBILE MD OHIO LLC
Practice address
6129 Nasby Dr
Galloway, OH 43119-8291
Phone
(317) 559-0950
NPI assigned
Jun 8, 2021
Last updated
Jul 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

6129 Nasby Dr
Galloway, OH 43119-8291

Mailing address

PO Box 586
Galloway, OH 43119-0586

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, WV, KY3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20210817003205 OH Part B Supplier - Clinic/Group Practice 7618372442 Receives reassigned benefits from 12 practitioners
Practice locations: Galloway, OH
O20251001001369 WV Part B Supplier - Clinic/Group Practice 7618372442 Receives reassigned benefits from 3 practitioners
Practice locations: Parkersburg, WV
O20260108001054 KY Part B Supplier - Clinic/Group Practice 7618372442 Receives reassigned benefits from 2 practitioners
Practice locations: Florence, KY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688601600000",
    "number": "1992372031",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6129 NASBY DR",
            "city": "GALLOWAY",
            "state": "OH",
            "postal_code": "431198291",
            "telephone_number": "317-559-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY MOBILE MD OHIO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-08",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "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 Galloway, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; 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.