Active NPI
Amanda D. Mulch, M.D.
- Obstetrics Physician
- Herrin, IL
National Provider Identifier
1609927870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics Physician
- License
- 40266
- Practice address
- 500 Rushing Dr
Herrin, IL 62948-3748 - Phone
- (618) 998-8808
- NPI assigned
- Jan 15, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Obstetrics Physician | 207VX0000X | 40266 | TN | Primary |
Addresses
Primary practice location
500 Rushing Dr
Herrin, IL 62948-3748
Mailing address
500 Rushing Dr
Herrin, IL 62948-3748
Phone (618) 998-8808
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40266 | TN | MD | Pharmacist |
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": "1183852800000",
"number": "1609927870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 RUSHING DR",
"city": "HERRIN",
"state": "IL",
"postal_code": "629483748",
"telephone_number": "618-998-8808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 RUSHING DR",
"city": "HERRIN",
"state": "IL",
"postal_code": "629483748",
"telephone_number": "618-998-8808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULCH",
"first_name": "AMANDA",
"middle_name": "D.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207VX0000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Obstetrics",
"state": "TN",
"license": "40266",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Herrin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.