Beth Kristen Mutch, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704237164 Issued in MI

Practice address

15959 Hall Rd
Suite 301
Macomb, MI 48044-3904

Phone

(586) 247-8609

Fax

(586) 247-8615

NPI assigned

Apr 10, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Oakland Macomb Obstetrics & Gynecology, PC

  • Obstetrics & Gynecology Physician
  • Rochester Hills, MI
  • NPI 1760424139
  Medicare reassignment NPD

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750504684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18076 HURON DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480422391",
            "telephone_number": "586-992-8798",
            "fax_number": "586-992-8798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15959 HALL RD",
            "address_2": "SUITE 301",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480443904",
            "telephone_number": "586-247-8609",
            "fax_number": "586-247-8615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTCH",
        "first_name": "BETH",
        "middle_name": "KRISTEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704237164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack Alonzo Moses Jr., D.C.
• Krystine Marie Muha, NP
• Kristen Mulville
• Ella Murkis
• Madellyn Murphy
• Amber Myers, AGACNP-BC
• Kristen Nicole Myers, P.T.
• Myeyedr Optometry of Michigan, LLC (MyEyeDr.)
• N & H Homecare Agency, LLC
• Prajesh Nandwana, R.PH

• Family Nurse Practitioner in Macomb, MI
• Providers in Macomb, MI by specialty
• Family Nurse Practitioner in Michigan

• 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.

Verify at the official NPI Registry.