NPIMap

Individual provider Active NPI

Joseph Michael Mulligan, CRNA

  • Certified Registered Nurse Anesthetist
  • Leitchfield, KY
National Provider Identifier
1689611469
Registry record updated Aug 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
28092549A Issued in IN
Practice address
515 Lake Front Rd.
Leitchfield, KY 42754
Phone
(270) 230-0377
NPI assigned
Jun 1, 2006
Last updated
Aug 7, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 28092549A IN Primary

Addresses

Primary practice location

515 Lake Front Rd.
Leitchfield, KY 42754

Mailing address

515 Lake Front Rd.
Leitchfield, KY 42754
Phone (270) 230-0377

Other identifiers 2

IdentifierTypeStateIssuer
10001010MedicaidIN
360955OtherININ BCBS ANTHEM PROVIDER #

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
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
159KYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Associates of Glasgow, PSC Nurse Anesthetist, Certified Registered PastSince Dec 18, 2015 Accepting new patients
Anesthesia Care Associates, LLC Nurse Anesthetist, Certified Registered PastSince Jan 4, 2012 Accepting new patients
Florida Gulf-to-Bay Anesthesiology Associates, LLC Past Accepting new patients
Anesthesiology Medical Services PSC Past Accepting new patients
Marion County Anesthesia Associates PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Digestive Care of Evansville PC Past Accepting new patients
Anesthesiology Associates of Glasgow PSC Nurse Anesthetist, Certified Registered Past Accepting new patients
Wabash Valley Anesthesia Nurse Anesthetist, Certified Registered Past Accepting new patients
Regional Anesthesia Group Inc Nurse Anesthetist, Certified Registered Past Accepting new patients

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186444800000",
    "number": "1689611469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 LAKE FRONT RD.",
            "city": "LEITCHFIELD",
            "state": "KY",
            "postal_code": "42754",
            "telephone_number": "270-230-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 LAKE FRONT RD.",
            "city": "LEITCHFIELD",
            "state": "KY",
            "postal_code": "42754",
            "telephone_number": "270-230-0377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIGAN",
        "first_name": "JOSEPH",
        "middle_name": "MICHAEL",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2007-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28092549A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10001010",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IN BCBS ANTHEM PROVIDER #",
            "identifier": "360955",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leitchfield, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.