Ryan David Mullins, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

04-36926 Issued in KS

Practice address

10234 Marion Park Dr
Kansas City, MO 64137-1405

Phone

(816) 201-3593

NPI assigned

Feb 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ryan.mullins.1@2636.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/2636/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Optumcare New Mexico LLC

  • Family Medicine Physician
  • Albuquerque, NM
  • NPI 1124053210
  Medicare reassignment NPD
• Taos Medical Group P a

  • Internal Medicine Physician
  • Taos, NM
  • NPI 1558392274
  Medicare reassignment NPD
• Physicians Caring for People

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1154329795
  NPD (past)
• Taos Health Systems, Inc., Holy Cross Hospital

  • Critical Access Hospital
  • Taos, NM
  • NPI 1902338049
  NPD (past)

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

{
    "created_epoch": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1063486801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10234 MARION PARK DR",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641371405",
            "telephone_number": "816-201-3593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10234 MARION PARK DR",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641371405",
            "telephone_number": "816-201-3593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "RYAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-16",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2014013905",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-36926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE TRINITY CLINIC",
            "identifier": "TAX ID PLUS 041",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE TRINITY CLINIC",
            "identifier": "TAX ID PLUS 088",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUPERIOR HEALTH/CHIPS",
            "identifier": "123633",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8P9043",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7164442",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144234506",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "752616977118",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Mullen, ACCNS-P
• Alicia Marie Muller, NP-C
• Laura Mullins, RNNNP
• Lisa Mullins
• Mary S Mullins, MED MFT LPC
• Benjamin Murry Mulloy, M.D.
• Carol Jean Mulvenon, APRN
• Elizabeth Ann Mulvenon, RN, MSN, FNP-C
• Melissa Mumper, BCBA
• Whitney Mundell

• Family Medicine Physician in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.