Active NPI
Mark A Mueller, MD
- Family Medicine Physician
- Spokane, WA
National Provider Identifier
1295755288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD60429813
- Practice address
- 10414 W Highway 2 Ste 10&11
Spokane, WA 99224-5348 - Phone
- (509) 838-2531
- Fax
- (509) 755-6580
- NPI assigned
- Jul 20, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0420009985 | VT | |
| Family Medicine Physician | 207Q00000X | 220232 | NY | |
| Family Medicine Physician | 207Q00000X | MD60429813 | WA | Primary |
Addresses
Primary practice location
10414 W Highway 2 Ste 10&11
Spokane, WA 99224-5348
Mailing address
PO Box 3649
Spokane, WA 99220-3649
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OVN2178 | Medicaid | VT | |
| 02065227 | Medicaid | NY |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 220232 | NY | MD | Family Medicine Physician |
| 0420009985 | VT | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rockwood Clinic PS | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Ambulatory Surgical Clinic/Center
- Spokane, WA
- NPI 1912252693
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389744000000",
"number": "1295755288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3649",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992203649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10414 W HIGHWAY 2 STE 10&11",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992245348",
"telephone_number": "509-838-2531",
"fax_number": "509-755-6580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUELLER",
"first_name": "MARK",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-20",
"last_updated": "2014-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "VT",
"license": "0420009985",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "220232",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD60429813",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "OVN2178",
"state": "VT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02065227",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.