Active NPI
Corazon Mulles, MD
- Internal Medicine Physician
- Montgomery, AL
National Provider Identifier
1659380368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 00020821
- Practice address
- 1000 Adams Ave
Montgomery, AL 36104-4424 - Phone
- (334) 420-5001
- Fax
- (334) 420-0146
- NPI assigned
- Aug 5, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 00020821 | AL | Primary |
Addresses
Primary practice location
1000 Adams Ave
Montgomery, AL 36104-4424
Mailing address
PO Box 70365
Montgomery, AL 36107-0365
Phone (334) 420-5001
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51079046 | Other | AL | BCBS |
| 630900043 | Medicaid | AL | |
| 630901043 | Medicaid | AL | |
| 630903043 | Medicaid | AL | |
| 4559602 | Other | AL | PPN |
| 51515589 | Other | AL | BCBS |
| P00039998 | Other | AL | MEDICARE RAILROAD |
| 51515590 | Other | AL | BCBS |
| 51515595 | Other | AL | BCBS |
| 630902043 | Medicaid | AL |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00020821 | AL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277683200000",
"number": "1659380368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 70365",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361070365",
"telephone_number": "334-420-5001",
"fax_number": "334-420-0146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 ADAMS AVE",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361044424",
"telephone_number": "334-420-5001",
"fax_number": "334-420-0146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLES",
"first_name": "CORAZON",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-05",
"last_updated": "2010-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AL",
"license": "00020821",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "51079046",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "630900043",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "630901043",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "630903043",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PPN",
"identifier": "4559602",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "51515589",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P00039998",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "51515590",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "51515595",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "630902043",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Montgomery, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.