NPIMap

Organization Active NPI

Lifecircle Womens Health Care PC

  • Obstetrics Physician
  • Cleveland, TN
National Provider Identifier
1316029663
Registry record updated May 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
Legal business name
LIFECIRCLE WOMENS HEALTH CARE PC
Practice address
2301 N Ocoee St Ste a
Cleveland, TN 37311-3869
Phone
(423) 339-1400
Fax
(423) 339-9950
NPI assigned
Oct 19, 2006
Last updated
May 25, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2022

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

Authorized official

Name
Christopher N. Mullin, MDNPI 1598738023
Title
Owner
Phone
(423) 339-1400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X NU
Obstetrics Physician 207VX0000X NU Primary

Addresses

Primary practice location

2301 N Ocoee St Ste a
Cleveland, TN 37311-3869

Mailing address

2301 N Ocoee St Ste a
Cleveland, TN 37311-3869
Phone (423) 339-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041227000438 TN Part B Supplier - Clinic/Group Practice 9931167707 Receives reassigned benefits from 12 practitioners
1 other NPI on this enrollment
Practice locations: Athens, TN; Cleveland, TN

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Lifecircle Womens Health3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2301 N Ocoee St
Cleveland, TN 37311
Phone (423) 339-1400

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653436800000",
    "number": "1316029663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 N OCOEE ST STE A",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113869",
            "telephone_number": "423-339-1400",
            "fax_number": "423-339-9950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 N OCOEE ST STE A",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113869",
            "telephone_number": "423-339-1400",
            "fax_number": "423-339-9950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFECIRCLE WOMENS HEALTH CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A",
        "authorized_official_last_name": "MULLIN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-339-1400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.