Active NPI
Chilango Mulaisho, MD
- Specialist
- Hermitage, TN
National Provider Identifier
1386600435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 31252
- Practice address
- 5653 Frist Blvd
Hermitage, TN 37076-2062 - Phone
- (615) 467-0206
- Fax
- (615) 467-0702
- NPI assigned
- Apr 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 31252 | TN | Primary |
Addresses
Primary practice location
5653 Frist Blvd
Hermitage, TN 37076-2062
Mailing address
5653 Frist Blvd
Suite 330
Hermitage, TN 37076-2062
Phone (615) 467-0206
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3843512 | Medicaid | TN |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31252 | TN | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279584000000",
"number": "1386600435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5653 FRIST BLVD",
"address_2": "SUITE 330",
"city": "HERMITAGE",
"state": "TN",
"postal_code": "370762062",
"telephone_number": "615-467-0206",
"fax_number": "615-467-0702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5653 FRIST BLVD",
"city": "HERMITAGE",
"state": "TN",
"postal_code": "370762062",
"telephone_number": "615-467-0206",
"fax_number": "615-467-0702"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULAISHO",
"first_name": "CHILANGO",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-25",
"last_updated": "2010-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "TN",
"license": "31252",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3843512",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hermitage, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.