Individual provider Active NPI

Athanas Mutiso

  • Home Health Aide
  • Rolla, MO
National Provider Identifier
1659270155
Registry record updated Nov 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
2227 Country Hills CT
Rolla, MO 65401-7102
Phone
(573) 501-4410
NPI assigned
Nov 2, 2026
Last updated
Nov 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health AideGroup: 193400000X SINGLE SPECIALTY GROUP 374U00000X Primary

Addresses

Primary practice location

2227 Country Hills CT
Rolla, MO 65401-7102

Mailing address

2227 Country Hills CT
Rolla, MO 65401-7102
Phone (573) 501-4410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1793577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793577600000",
    "number": "1659270155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2227 COUNTRY HILLS CT",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654017102",
            "telephone_number": "573-501-4410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2227 COUNTRY HILLS CT",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654017102",
            "telephone_number": "573-501-4410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTISO",
        "first_name": "ATHANAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-11-02",
        "last_updated": "2026-11-02",
        "certification_date": "2026-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolla, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.