Gary Thomas Mutch, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

19870 Issued in NC

Practice address

117 E Kings Hwy
Eden, NC 27288-5201

Phone

(336) 623-9711

Fax

(336) 623-7660

NPI assigned

Jul 12, 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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

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.

• Unc Rockingham Health Care, Inc.

  dba UNC Rockingham Hospital

  • General Acute Care Hospital
  • Eden, NC
  • NPI 1326048810
  NPD (past)
• Mymichigan Medical Center Alpena

  • Internal Medicine Physician
  • Alpena, MI
  • NPI 1942302302
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197590400000",
    "number": "1356366462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 E KINGS HWY",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885201",
            "telephone_number": "336-623-9711",
            "fax_number": "336-623-7660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 E KINGS HWY",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885201",
            "telephone_number": "336-623-9711",
            "fax_number": "336-623-7660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTCH",
        "first_name": "GARY",
        "middle_name": "THOMAS",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "19870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8961636",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6056601",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Moses Cone Affiliated Physicians, Inc. (Premier Pediatrics of Eden)
• Moses Cone Affiliated Physicians, Inc. (Rockingham Eye Associates, PA)
• Chelsea Turner Motley, COTA/L
• Moving on Faith Transportation LLC
• Reginald Musekiwa, OT
• Myeyedr Optometry of North Carolina PLLC (MyEyeDr)
• Carl W. Nash, M.D.
• NC Emergency Physician Services, PLLC
• Eric Sherwood Neijstrom, M.D.
• New Abundant Living 3

• Emergency Medicine Physician in Eden, NC
• Providers in Eden, NC by specialty
• Emergency Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2007; 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.