Mullock Health Care LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MULLOCK HEALTH CARE LLC

Practice address

2332 S Main St
Maryville, MO 64468-3622

Phone

(660) 562-2223

Fax

(660) 562-2230

NPI assigned

Jan 20, 2020

Last updated

May 6, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dallas Wayne Mullock, DONPI 1134504012

Title

Owner

Phone

(660) 562-2223

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dallas Mullock, D.O.

  • Family Medicine Physician
  • Maryville, MO
  • NPI 1134504012
  Medicare reassignment NPD Authorized official
• Travis Tyler Hawks, M.D.

  • Family Medicine Physician
  • Lockwood, MO
  • NPI 1700053444
  Medicare reassignment NPD
• William Park Triplett, MD

  • Family Medicine Physician
  • Carthage, MO
  • NPI 1730196080
  Medicare reassignment NPD
• Stephen Ray Goff

  • Nursing Home Administrator
  • Grant City, MO
  • NPI 1588338560
  NPD (past)

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

{
    "created_epoch": "1579478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714953600000",
    "number": "1881224707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2332 S MAIN ST",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644683622",
            "telephone_number": "660-562-2223",
            "fax_number": "660-562-2230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2332 S MAIN ST",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644683622",
            "telephone_number": "660-562-2223",
            "fax_number": "660-562-2230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MULLOCK HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-20",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A",
        "authorized_official_last_name": "MULLOCK",
        "authorized_official_first_name": "DALLAS",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "660-562-2223",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mosaic Medical Center - Maryville
• Mosaic Medical Center - Maryville (Mosaic Behavioral Health - Maryville)
• Mosaic Medical Center - Maryville (Mosaic Skilled Nursing - Maryville)
• Mosaic Medical Center - Maryville (Mosaic Specialty Care - East)
• Mosaic Medical Center - Maryville (Mosaic Specialty Care - West)
• Dallas Mullock, D.O.
• Martha R. Mustion, F.N.P.
• Estella Myrick, FNP
• N & R of Maryville LLC (Maryville Living Center)
• Margaret Rose Nelson, MS, LPC, LCSW

• Clinic/Center in Maryville, MO
• Providers in Maryville, MO by specialty
• Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.