Individual provider Active NPI

Amy C Mullin, FNP-C

  • Adult Health Nurse Practitioner
  • Chattanooga, TN
National Provider Identifier
1396896601
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APN0000012399 Issued in TN
Practice address
2339 McCallie Ave
Suite 309
Chattanooga, TN 37404-3256
Phone
(423) 698-0850
Fax
(423) 698-0511
NPI assigned
Jan 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APN0000012399 TN Primary

Addresses

Primary practice location

2339 McCallie Ave
Suite 309
Chattanooga, TN 37404-3256

Mailing address

2339 McCallie Ave
Suite 309
Chattanooga, TN 37404-3256
Phone (423) 698-0850

Other identifiers 4

IdentifierTypeStateIssuer
F0806230OtherTNNP CERTIFICATION
RN0000119811OtherTNRN LICENSE
APN0000012399OtherTNADVANCED PRACTICE NURSE
RN171509OtherGARN LICENSE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
APN0000012399TNMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Specialists in Pain Management, PLLC Dba Spine & Pain Associates Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1396896601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2339 MCCALLIE AVE",
            "address_2": "SUITE 309",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374043256",
            "telephone_number": "423-698-0850",
            "fax_number": "423-698-0511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2339 MCCALLIE AVE",
            "address_2": "SUITE 309",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374043256",
            "telephone_number": "423-698-0850",
            "fax_number": "423-698-0511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIN",
        "first_name": "AMY",
        "middle_name": "C",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TN",
            "license": "APN0000012399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP CERTIFICATION",
            "identifier": "F0806230",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "RN0000119811",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCED PRACTICE NURSE",
            "identifier": "APN0000012399",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "RN171509",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.