Robert J Mulloy, A.N.P,
Individual provider Active NPI Adult Health Nurse Practitioner · Saint Ann, MO
NPI 1528299039 · NPPES record last updated Jan 30, 2025
Key facts
- NPI
- 1528299039
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- 2004018905 (MO)
- Practice address
- 11063 Saint Francis LN
Saint Ann, MO 63074-3333 - Phone
- (314) 680-3761
- NPI assigned
- Jul 31, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sound Physicians of Illinois LLC
Practice addresses (Care Compare)
12303 De Paul Dr
Bridgeton, MO 63044-2512
Phone (314) 344-6000
Hospital & facility affiliations
- SSM Health Depaul Hospital St Louis
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091023000054 | MO | Practitioner - Nurse Practitioner | 2567509524 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sound Physicians of Illinois, LLC | Current |
Accepting new patients |
Locations
2100 Madison Ave
Granite City, IL 62040
Phone (618) 798-3000
8 Doctors Park Rd
Mount Vernon, IL 62864
Phone (618) 244-5500
12303 De Paul Dr
Bridgeton, MO 63044
Phone (314) 344-6360
300 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 669-2211
6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442
120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040
Interoperability endpoints
- rmulloy@yourcarecommunity.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 2004018905 | MO | Yes |
Addresses
Primary practice location
11063 Saint Francis LN
Saint Ann, MO 63074-3333
Mailing address
11063 Saint Francis LN
Saint Ann, MO 63074-3333
Phone (314) 680-3761
Other providers in Saint Ann, MO
- Medicine Shoppe
- Brenda Mills
- Kathryn Moffat
- Monaco & Badihi DDS PC
- MSC Health Services, LLC
- My Pleasure Hoome Health Care LLC
- Ebony Nicole Nebbitt
- John Joseph O'Connell
- One Power in Home CDS
- One Power in-Home Care CDS, Inc.
All providers in Saint Ann, MO · Adult Health Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 30, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.