Active NPI
David Thomas Mullin, D.C., M.A.O.M.
- Chiropractor
- Springfield, MO
National Provider Identifier
1942212451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2004008980
- Practice address
- 1266 E Republic Rd
Springfield, MO 65804-7209 - Phone
- (417) 882-1000
- Fax
- (417) 447-1769
- NPI assigned
- Aug 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2004008980 | MO | Primary |
| Acupuncturist | 171100000X | 2004008980 | MO |
Addresses
Primary practice location
1266 E Republic Rd
Springfield, MO 65804-7209
Mailing address
175 Waterfall Dr
Ozark, MO 65721-9535
Phone (417) 343-8854
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 190381 | Other | MO | BLUE CROSS BLUE SHIELD |
| 226762 | Other | MO | COVENTRY |
| 9355033 | Other | MO | PHCS |
| 667565 | Other | MO | UNITED HEALTH CARE |
| 674377 | Other | MO | HEALTHLINK |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC28136 | CA | MD | Sports Physician Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195516800000",
"number": "1942212451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 WATERFALL DR",
"city": "OZARK",
"state": "MO",
"postal_code": "657219535",
"telephone_number": "417-343-8854",
"fax_number": "417-447-1769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1266 E REPUBLIC RD",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658047209",
"telephone_number": "417-882-1000",
"fax_number": "417-447-1769"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLIN",
"first_name": "DAVID",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "D.C., M.A.O.M.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-13",
"last_updated": "2007-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MO",
"license": "2004008980",
"primary": true
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "MO",
"license": "2004008980",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "190381",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COVENTRY",
"identifier": "226762",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHCS",
"identifier": "9355033",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "667565",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "674377",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.