SOUTHERN MOBILE MEDICAL GROUP PA
NPI 1730903675
General Practice in Charlotte, NC
About Southern Mobile Medical Group Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHERN MOBILE MEDICAL GROUP PA (NPI 1730903675) is a healthcare organization registered as a general practice in Charlotte, North Carolina and active in the NPI registry since November 2024. The organization lists Zachary Mandler, Director Of Contracting, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Southern Mobile Medical Group Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
14Medicare enrollment records show 14 clinicians reassign Medicare billing to Southern Mobile Medical Group PA, which bills Medicare for the services they deliver. Of these, 3 practice within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 2
Clinicians, nearest first (14)
Charlotte, NC 28262
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 Southern Mobile Medical Group PA's NPI number?
The NPI number for Southern Mobile Medical Group PA is 1730903675. It was assigned to this organization in the NPPES registry on November 7, 2024.
Where is Southern Mobile Medical Group PA located?
Southern Mobile Medical Group PA is located at 5804 Monroe Rd Ste C, Charlotte, NC 28212. The listed phone number is (385) 499-5535.
What is Southern Mobile Medical Group PA's specialty?
The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.
Is Southern Mobile Medical Group PA enrolled in Medicare?
Yes. Southern Mobile Medical Group PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Southern Mobile Medical Group PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 14 clinicians in 2 Medicare specialties reassign their Medicare billing to Southern Mobile Medical Group PA. 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. The largest specialties are Nurse Practitioner (12) and Family Practice (2). Of these, 3 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Southern Mobile Medical Group PA was last updated on February 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.
# Southern Mobile Medical Group Pa · NPI 1730903675
General Practice organization in Charlotte, North Carolina. Organization record, active in the CMS NPPES registry since November 7, 2024.
## Identity
- **NPI:** 1730903675 (Entity type: Organization)
- **Enumerated:** November 7, 2024
- **Primary specialty:** General Practice · taxonomy 208D00000X
- **Organization subpart:** No
- **Authorized official:** Zachary Mandler, DIRECTOR OF CONTRACTING
## Practice location
- **Address:** 5804 MONROE RD STE C, Charlotte, NC 28212-6183
- **Phone:** (385) 499-5535
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 14 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (12), Family Practice (2); 3 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 24, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1730903675) · Data from the CMS NPPES public registry.