Individual provider Active NPI

John Randolph Mullins, MD

  • Vascular Surgery Physician
  • Springfield, MO
National Provider Identifier
1396784377
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
114866 Issued in MO
Practice address
3800 S National Ave
Springfield, MO 65807-5209
Phone
(417) 875-3000
Fax
(417) 875-3737
NPI assigned
Jun 6, 2006
Last updated
Apr 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 114866 MO Primary

Addresses

Primary practice location

3800 S National Ave
Springfield, MO 65807-5209

Mailing address

PO Box 505673
Saint Louis, MO 63150-5673

Other identifiers 2

IdentifierTypeStateIssuer
114254OtherBLUE CROSS/BLUE SHIELD
206962813MedicaidMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050817000006 MO Practitioner - Vascular SurgeryPractitioner - General Surgery 9436189750 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
University of Oklahoma College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lester E Cox Medical CentersGroup PAC ID 1254248917, 336 clinicians

Practice addresses (Care Compare)

3800 S National Ave
Suite 160
Springfield, MO 65807-5228
Phone (417) 875-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.52 of 100Reported as group
Quality
61.64
Promoting interoperability
100
Improvement activities
40
Cost
76.77

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion11

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E Cox Medical Centers CurrentSince Jun 1, 2022 Accepting new patients
Lester E Cox Medical Centers CurrentSince Nov 1, 2020 Accepting new patients
Lester E Cox Medical Centers Vascular Surgery CurrentSince Jun 1, 2022 Accepting new patients
Lester E Cox Medical Centers CurrentSince Nov 1, 2020 Accepting new patients
Lester E Cox Medical Centers Current Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1500 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-6000

1000 E Primrose St
Ste 360
Springfield, MO 65807
Phone (417) 269-4037

1001 E Primrose St
Springfield, MO 65807
Phone (417) 875-3434

1001 E Primrose St
Ste 200
Springfield, MO 65807
Phone (417) 875-3275

3525 S National Ave
Ste 101
Springfield, MO 65807
Phone (417) 269-9950

3800 S National Ave
Springfield, MO 65807
Phone (417) 269-0565

3800 S National Ave
Fl 4
Springfield, MO 65807
Phone (417) 875-3203

3800 S National Ave
Ste 160
Springfield, MO 65807
Phone (417) 875-2624

3800 S National Ave
Ste 400
Springfield, MO 65807
Phone (417) 269-9482

3805 S Kansas Expy
Ste B
Springfield, MO 65807
Phone (417) 269-0269

Interoperability endpoints

  • Direct secure messaging: j.mullins@cernerdirect.coxhealth.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1396784377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505673",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631505673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 S NATIONAL AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075209",
            "telephone_number": "417-875-3000",
            "fax_number": "417-875-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "JOHN",
        "middle_name": "RANDOLPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MO",
            "license": "114866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "114254",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206962813",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.