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Individual provider Active NPI

Christopher James Mulder, DO

  • Gastroenterology Physician
  • Clive, IA
National Provider Identifier
1356577951
Registry record updated Nov 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
DO-05475 Issued in IA
Practice address
1378 NW 124TH St # 8151
Clive, IA 50325-8151
Phone
(515) 288-6097
NPI assigned
Jun 9, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DOS-1377 HI
Gastroenterology Physician 207RG0100X DOS - 1377 HI
Gastroenterology Physician 207RG0100X DO-05475 IA Primary

Addresses

Primary practice location

1378 NW 124TH St # 8151
Clive, IA 50325-8151

Mailing address

1378 NW 124TH St # 8151
Clive, IA 50325-8151
Phone (515) 288-6097

Other practice location 1

1650 Cochrane Cir
Fort Carson, CO 80913-4613
Phone (608) 449-8006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200617000141 IA Practitioner - GastroenterologyPractitioner - Internal Medicine 3375847106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iowa Digestive Disease Center PCGroup PAC ID 4183522188, 24 clinicians

Practice addresses (Care Compare)

1378 NW 124TH St
Suite 200
Clive, IA 50325-8151
Phone (515) 288-6097

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy109
Upper gastrointestinal (GI) endoscopy for acid reflux183

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DOS-1377HIMDInternal Medicine Physician
DOS - 1377HIMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Methodist Hospital Current Accepting new patients
Iowa Digestive Disease Center P.C. Gastroenterology CurrentSince Aug 1, 2020 Accepting new patients

Locations

1378 NW 124th St
#8151
Clive, IA 50325
Phone (515) 288-6097

1378 NW 124th St
Ste 200
Clive, IA 50325
Phone (515) 288-6097

Interoperability endpoints

  • Direct secure messaging: cmulder753835@direct.unitypoint.org
  • Direct secure messaging: cmulder3962236@direct.trinity-health.org

Organizations & group practices 2

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1244505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1356577951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1378 NW 124TH ST # 8151",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258151",
            "telephone_number": "515-288-6097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1378 NW 124TH ST # 8151",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258151",
            "telephone_number": "515-288-6097"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 Cochrane Cir",
            "address_purpose": "LOCATION",
            "city": "Fort Carson",
            "state": "CO",
            "postal_code": "809134613",
            "country_code": "US",
            "telephone_number": "608-449-8006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULDER",
        "first_name": "CHRISTOPHER",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-09",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "DOS-1377",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "HI",
            "license": "DOS - 1377",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IA",
            "license": "DO-05475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clive, IA

Sources for this page

Verify at the official NPI Registry.