Active NPI
My Mobile MD Ohio LLC
- Family Medicine Physician
- Galloway, OH
National Provider Identifier
1992372031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- 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
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 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, KY
Enrollment records 3
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryPractitioners & affiliated clinicians
Practitioners 15
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Gerontology Nurse Practitioner
- Galloway, OH
- NPI 1144601410
KY, OH, Single Specialty
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.