MOBILE MEDICAL GROUP
NPI 1407469166
Nurse Practitioner in Meridian, ID

Q: What is Mmg LLC's NPI number?

The NPI number for Mmg LLC is 1407469166. It was assigned to this organization in the NPPES registry on August 24, 2020. The provider is doing business as Mobile Medical Group.

Q: What is Mmg LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Mmg LLC was last updated on July 22, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 24, 2020

2440 S TITANIUM PL, MERIDIAN, ID 83642(208) 456-2659(208) 454-0854 Get Directions Write a Review

NPPES record last updated: July 22, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 22, 2022, Aug 27, 2020 (2 updates tracked since 2020).

On this page

About Mobile Medical Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOBILE MEDICAL GROUP (NPI 1407469166) is a healthcare organization registered as a nurse practitioner in Meridian, Idaho and active in the NPI registry since August 2020. The organization lists Kenneth E Norris, Managing Partner, as its authorized official.

NPPES Registry Identity

NPI1407469166

Entity TypeOrganization

Primary Taxonomy363L00000X

Legal Business NameMMG LLC

Location Address2440 S TITANIUM PLMeridian, ID 83642-6703

Mailing Address450 S 900 E Ste 100Salt Lake City, UT 84102-2983 · (801) 456-6166 · Fax (801) 531-1949

Phone(208) 456-2659

Fax(208) 454-0854

Organization SubpartNo

Authorized OfficialKenneth E NorrisManaging Partner · (801) 485-6166

Enumeration DateAugust 24, 2020

Last NPPES UpdateJuly 22, 20222 updates tracked since enumeration

NPPES CertifiedJuly 22, 2022

✔ NPI 1407469166 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

2440 S TITANIUM PL, Meridian, ID 83642

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Other Names 1

Doing Business AsMobile Medical Group

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mobile Medical Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 3 clinicians reassign Medicare billing to Mobile Medical Group, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Erin Wonenberg, AGACNP-BC

Nurse Practitioner

NPI 1689360240

6140 W CURTISIAN AVE STE 200
Boise, ID 83704

(208) 302-0000

✔ PECOS5.3 mi

Jessica Long, AGNP-C

Nurse Practitioner

NPI 1194244707

420 E STATE ST STE 135
Eagle, ID 83616

(208) 402-9956

✔ PECOS✔ Accepts Medicare7.8 mi

Aimee Shepard, FNP-C

Nurse Practitioner

NPI 1154092427

3719 WHEELER CIR
Nampa, ID 83686

(208) 695-0388

✔ PECOS✔ Accepts Medicare10 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mmg LLC's NPI number?

The NPI number for Mmg LLC is 1407469166. It was assigned to this organization in the NPPES registry on August 24, 2020. The provider is doing business as Mobile Medical Group.

Where is Mmg LLC located?

Mmg LLC is located at 2440 S Titanium Pl, Meridian, ID 83642. The listed phone number is (208) 456-2659.

What is Mmg LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Mmg LLC enrolled in Medicare?

Yes. Mmg LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mmg LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Mmg LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Mmg LLC accept?

Health plans from Molina Healthcare list Mmg LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mmg LLC was last updated on July 22, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.