Charles C Mulry, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

01035356 Issued in IN

Practice address

5901 Technology Center Dr
Indianapolis, IN 46278-6013

Phone

(317) 328-4777

Fax

(317) 715-9965

NPI assigned

Jul 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Diagnostic Radiology

Education

University of Nebraska College of Medicine, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Riverview HospitalGroup PAC ID 1153216627, 209 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Riverview Hospital

  • Family Medicine Physician
  • Noblesville, IN
  • NPI 1609074921
  Medicare reassignment Care Compare group NPD
• Northwest Radiology Network P C

  • Diagnostic Radiology Physician
  • Indianapolis, IN
  • NPI 1447259338
  Medicare reassignment NPD
• Riverview Hospital

  • Skilled Nursing Facility
  • Indianapolis, IN
  • NPI 1831164995
  NPD
• Madison County Imaging PC

  • Diagnostic Radiology Physician
  • Anderson, IN
  • NPI 1669488037
  NPD (past)
• Rush Memorial Hospital

  • Rural Health Clinic/Center
  • Rushville, IN
  • NPI 1659935781
  NPD (past)
• St Vincent Northwest Radiology LLC

  • Diagnostic Radiology Physician
  • Fishers, IN
  • NPI 1114978350
  NPD (past)

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475452800000",
    "number": "1255358149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 TECHNOLOGY CENTER DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462786013",
            "telephone_number": "317-328-4777",
            "fax_number": "317-715-9965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 TECHNOLOGY CENTER DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462786013",
            "telephone_number": "317-328-4777",
            "fax_number": "317-715-9965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULRY",
        "first_name": "CHARLES",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2016-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01035356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100332640",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian Heath Mullis, MD
• Leilani Saum Mullis, MD
• Macy Mullis, RBT
• Eva W Muloma, MD
• Kirk Daniel Mulroney, PT MS
• Sukhpreet Singh Multani, MD
• Multiple Pathways to Recovery LLC
• Dallas E Mulvaney, PHD, HSPP
• Jack Mumaugh, PT, DPT
• Cassidy Morrow Mumbower, PA-C

• Diagnostic Radiology Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Diagnostic Radiology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.