NPIMap

Individual provider Active NPI

Gennie Marie Mullen, APRN-C

  • Family Nurse Practitioner
  • Chanute, KS
National Provider Identifier
1447802137
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
78874 Issued in KS
Practice address
1501 W 7TH St Ste 2
Chanute, KS 66720-2516
Phone
(620) 243-2558
Fax
(620) 431-1192
NPI assigned
Jul 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 78874 KS Primary

Addresses

Primary practice location

1501 W 7TH St Ste 2
Chanute, KS 66720-2516

Mailing address

PO Box 426
Chanute, KS 66720-0426
Phone (620) 244-5105

Other identifiers 1

IdentifierTypeStateIssuer
78874OtherKSKS APRN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20190819002569 KS Practitioner - Nurse Practitioner 7719215599 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neosho Memorial Regional Medical CenterGroup PAC ID 9133022882, 26 clinicians

Practice addresses (Care Compare)

13920 Hwy 59
Erie, KS 66733-5001
Phone (620) 244-5784

Hospital & facility affiliations

  • Neosho Memorial Regional Medical Center Hospital, Chanute, KS, CCN 171380
  • Labette Health Hospital, Parsons, KS, CCN 170120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neosho Memorial Regional Medical Center Current Accepting new patients
Neosho Memorial Regional Medical Center CurrentSince Jul 12, 2019 Accepting new patients
Nmrmc Urology Clinic CurrentSince Jul 12, 2019 Accepting new patients
Neosho Memorial Regional Medical Center Current Accepting new patients
Neosho Memorial Regional Medical Center PastSince Oct 1, 2021 Accepting new patients
Neosho Memorial Regional Medical Center Past Accepting new patients

Locations

1501 W 7th St
Ste 2
Chanute, KS 66720
Phone (620) 432-5200

629 S Plummer Ave
Chanute, KS 66720
Phone (316) 431-4000

2522 W 21st St
Chanute, KS 66720
Phone (620) 431-4000

13920 Highway 59
Erie, KS 66733
Phone (620) 244-5700

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/a9daee2a-e42f-4702-9c42-486fbda403f6/

Organizations & group practices 10

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 4

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": "1562889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1447802137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 426",
            "city": "CHANUTE",
            "state": "KS",
            "postal_code": "667200426",
            "telephone_number": "620-244-5105",
            "fax_number": "620-244-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 W 7TH ST STE 2",
            "city": "CHANUTE",
            "state": "KS",
            "postal_code": "667202516",
            "telephone_number": "620-243-2558",
            "fax_number": "620-431-1192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "GENNIE",
        "middle_name": "MARIE",
        "credential": "APRN-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-12",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "78874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KS APRN LICENSE",
            "identifier": "78874",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chanute, KS

Sources for this page

Verify at the official NPI Registry.