Individual provider Active NPI

Chrystah Mullins

  • Case Manager/Care Coordinator
  • Richmond, KY
National Provider Identifier
1235531773
Registry record updated Sep 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
415 Gibson LN
Richmond, KY 40475-2577
Phone
(859) 623-6401
NPI assigned
Sep 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

415 Gibson LN
Richmond, KY 40475-2577

Mailing address

415 Gibson LN
Richmond, KY 40475-2577
Phone (859) 623-6401

Other identifiers 1

IdentifierTypeStateIssuer
1790731081MedicaidKY

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": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411516800000",
    "number": "1235531773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 GIBSON LN",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404752577",
            "telephone_number": "859-623-6401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 GIBSON LN",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404752577",
            "telephone_number": "859-623-6401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "CHRYSTAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-16",
        "last_updated": "2014-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790731081",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.