1. Home
  2. Directory
  3. Missouri
  4. Maryville
  5. Clinic Center
  6. NPI Profile

MULLOCK HEALTH CARE LLC
NPI 1881224707
Clinic/Center in Maryville, MO

Active since January 20, 2020CLIA 26D2183013 · Waiver
2332 S MAIN ST, MARYVILLE, MO 64468(660) 562-2223(660) 562-2230 Get Directions Write a Review

NPPES record last updated: May 6, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 6, 2024, Jan 20, 2020 (2 updates tracked since 2020).

About Mullock Health Care Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MULLOCK HEALTH CARE LLC (NPI 1881224707) is a healthcare organization registered as a clinic/center in Maryville, Missouri and active in the NPI registry since January 2020. The organization holds a CLIA Waiver certificate valid through April 27, 2028 and lists Dallas Wayne Mullock, Owner, as its authorized official.

NPPES Registry Identity

NPI1881224707
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameMULLOCK HEALTH CARE LLC
Location Address2332 S MAIN STMaryville, MO 64468-3622
Mailing Address2332 S Main StMaryville, MO 64468-3622 · (660) 562-2223 · Fax (660) 562-2230
Phone(660) 562-2223
Fax(660) 562-2230
Organization SubpartNo
Authorized OfficialDallas Wayne MullockOwner · (660) 562-2223
Enumeration DateJanuary 20, 2020
Last NPPES UpdateMay 6, 20242 updates tracked since enumeration
NPPES CertifiedMay 6, 2024
✔ NPI 1881224707 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
2332 S MAIN ST, Maryville, MO 64468
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mullock Health Care Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Mullock Health Care LLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Dallas Mullock, D.O.
Family Practice
NPI 1134504012
2332 S MAIN ST
Maryville, MO 64468
(660) 562-2223
✔ PECOS✔ Accepts Medicare5.3 mi
Travis Hawks, M.D.
Family Practice
NPI 1700053444
1307 S MAIN ST
Lockwood, MO 65682
(417) 232-4560
✔ PECOS✔ Accepts Medicare211 mi
William Triplett, MD
Family Practice
NPI 1730196080
3125 DR RUSSELL SMITH WAY
Carthage, MO 64836
(417) 359-1380
✔ PECOS✔ Accepts Medicare224 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D2183013

Mullock Health Care LLC · Maryville, MO
Active · expires Apr 27, 2028
CLIA Number26D2183013
Laboratory TypePhysician Office
Certificate Effective DateApril 28, 2026
Certificate Expiration DateApril 27, 2028
Laboratory DirectorDallas W. Mullock
Laboratory Phone(660) 562-2223
Laboratory LocationMullock Health Care LLC2332 S Main St, Maryville, MO 64468
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mullock Health Care LLC's NPI number?

The NPI number for Mullock Health Care LLC is 1881224707. It was assigned to this organization in the NPPES registry on January 20, 2020.

Where is Mullock Health Care LLC located?

Mullock Health Care LLC is located at 2332 S Main St, Maryville, MO 64468. The listed phone number is (660) 562-2223.

What is Mullock Health Care LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Is Mullock Health Care LLC enrolled in Medicare?

Yes. Mullock Health Care LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mullock Health Care LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Family Practice, reassign their Medicare billing to Mullock Health Care LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Mullock Health Care LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D2183013) is associated with this NPI, valid through April 27, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Mullock Health Care LLC accept?

Health plans from Anthem Blue Cross and Blue Shield list Mullock Health Care LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mullock Health Care LLC was last updated on May 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.