NPIMap

Individual provider Active NPI

Alyssa L Mullins, D.O.

  • Family Medicine Physician
  • Russell Springs, KY
National Provider Identifier
1174100895
Registry record updated Jul 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
05796 Issued in KY
Practice address
404 Steve Drive
Russell Springs, KY 42642-4622
Phone
(270) 866-3161
Fax
(270) 866-3163
NPI assigned
Mar 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 05796 KY Primary

Addresses

Primary practice location

404 Steve Drive
Russell Springs, KY 42642-4622

Mailing address

PO Box 1080
Burkesville, KY 42717-1080
Phone (270) 858-6655

Other names 1

  • Alyssa Kozacek Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240905002147 KY Practitioner - Family Practice 2264972207 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

350 Hospital Way
Suite 100
Somerset, KY 42503-1872
Phone (606) 451-2600

360 Keen St
Burkesville, KY 42717-7915
Phone (270) 864-2889

404 Steve Dr
Russell Springs, KY 42642-4622
Phone (270) 866-3161

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland Family Medical Center Inc CurrentSince Aug 26, 2024 Accepting new patients
Lake Cumberland Regional Hospital LLC CurrentSince Dec 22, 2024 Accepting new patients
Lake Cumberland Regional Hospital, LLC Family Medicine CurrentSince Dec 22, 2024 Accepting new patients
Cumberland Family Medical Center Inc CurrentSince Aug 26, 2024 Accepting new patients
Lake Cumberland Regional Hospital LLC Family Medicine Current Accepting new patients
Cumberland Family Medical Center Inc Current Accepting new patients
Cumberland Family Medical Center Inc Past Accepting new patients

Locations

360 Keen St
Burkesville, KY 42717
Phone (270) 864-1472

404 Steve Dr
Russell Springs, KY 42642
Phone (270) 866-3161

353 Bogle St
Ste A
Somerset, KY 42503
Phone (606) 451-3820

350 Hospital Way
Ste 100
Somerset, KY 42503
Phone (606) 451-2600

350 Hospital Way
Somerset, KY 42503
Phone (606) 451-2600

Interoperability endpoints

  • Direct secure messaging: alyssa.kozacek.1@21269.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/21269/brand/3/csg/1/fhir/r4

Organizations & group practices 7

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1616803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785369600000",
    "number": "1174100895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1080",
            "city": "BURKESVILLE",
            "state": "KY",
            "postal_code": "427171080",
            "telephone_number": "270-858-6655",
            "fax_number": "270-858-4027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 STEVE DRIVE",
            "city": "RUSSELL SPRINGS",
            "state": "KY",
            "postal_code": "426424622",
            "telephone_number": "270-866-3161",
            "fax_number": "270-866-3163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "ALYSSA",
        "middle_name": "L",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-27",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "05796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "KOZACEK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Russell Springs, KY

Sources for this page

Verify at the official NPI Registry.