Mutigen, LLC

Primary specialty

ContractorTaxonomy code 171W00000X

License

MD35884 Issued in TN

Legal business name

MUTIGEN, LLC

Practice address

711 N Atlantic St
Tullahoma, TN 37388

Phone

(931) 967-2681

NPI assigned

Apr 7, 2008

Organization subpart

No

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

Authorized official

Name

Marcus William LeeNPI 1457364077

Title

Owner/Ceo

Phone

(931) 455-2273

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Tullahoma Hma LLC

  • General Acute Care Hospital
  • Tullahoma, TN
  • NPI 1922052869

  Member Of

  NPD member

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marcus William Lee, MD

  • Family Medicine Physician
  • Tullahoma, TN
  • NPI 1457364077
  Medicare reassignment Care Compare group NPD Authorized official
• Megan Elaine Lubben, PA

  • Physician Assistant
  • Tullahoma, TN
  • NPI 1417630856
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727740800000",
    "number": "1356514848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1900",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373881900",
            "telephone_number": "993-131-4559",
            "fax_number": "931-563-7659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 N ATLANTIC ST",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "37388",
            "telephone_number": "931-967-2681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUTIGEN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-07",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "931-455-2273"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Contractor",
            "state": "TN",
            "license": "MD35884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1457364077",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Claire Mullins
• Paul Martin Mulroy, L.P.C.MHSP
• Matthew Daniel Murphey, DPM
• Heather Musall
• Gregory Leonard Muse, OD
• Zachary Myers
• Madeleine Nagy, OTR/L
• National Urgent Care Clinics, LLC
• Ryan Neal
• NHC Healthcare-Tullahoma LLC

• Contractor in Tullahoma, TN
• Providers in Tullahoma, TN by specialty
• Contractor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.