Active NPI
Dennis W. McMullen, MD
- Diagnostic Radiology Physician
- Silver City, NM
National Provider Identifier
1558339622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 79-216
- Practice address
- 1313 E. 32ND St
Silver City, NM 88061 - Phone
- (575) 532-7000
- NPI assigned
- Mar 14, 2006
- Last updated
- Jul 1, 2009
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 79-216 | NM | Primary |
Addresses
Primary practice location
1313 E. 32ND St
Silver City, NM 88061
Mailing address
205 W. Boutz Rd. BLDG #1
Las Cruces, NM 88005
Phone (575) 532-7000
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NM002038 | Other | NM | BCBS OF NM |
| 10004752 | Other | NM | LOVELACE |
| 300018733 | Other | RR MEDICARE | |
| 06338 | Medicaid | NM |
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 |
|---|---|---|---|
| 79-216 | NM | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1246406400000",
"number": "1558339622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 W. BOUTZ RD. BLDG #1",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "88005",
"telephone_number": "575-532-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1313 E. 32ND ST",
"city": "SILVER CITY",
"state": "NM",
"postal_code": "88061",
"telephone_number": "575-532-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMULLEN",
"first_name": "DENNIS",
"middle_name": "W.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-14",
"last_updated": "2009-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NM",
"license": "79-216",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF NM",
"identifier": "NM002038",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LOVELACE",
"identifier": "10004752",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "300018733",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "06338",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Silver City, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.