Active NPI
Maxton Mullis
- Student in an Organized Health Care Education/Training Program
- Cedar Falls, IA
National Provider Identifier
1164301040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 2351 Hudson Rd
Cedar Falls, IA 50614-0065 - Phone
- (563) 690-8515
- NPI assigned
- Aug 27, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
2351 Hudson Rd
Cedar Falls, IA 50614-0065
Mailing address
137 14TH Ave SW
Dyersville, IA 52040-1769
Phone (563) 690-8515
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1756252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756252800000",
"number": "1164301040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "137 14TH AVE SW",
"city": "DYERSVILLE",
"state": "IA",
"postal_code": "520401769",
"telephone_number": "563-690-8515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2351 HUDSON RD",
"city": "CEDAR FALLS",
"state": "IA",
"postal_code": "506140065",
"telephone_number": "563-690-8515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLIS",
"first_name": "MAXTON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-08-27",
"last_updated": "2025-08-27",
"certification_date": "2025-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cedar Falls, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.