MR. JEFFREY CHARLES MUNDT NP NPI 1174669808

NPI Information

  • NPI: 1174669808
  • Provider Name: MR. JEFFREY CHARLES MUNDT, NP
  • Classification: Nurse Practitioner - 363LA2200X
  • Specialization: Adult Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 43475 DALCOMA DR STE 160
    CLINTON TOWNSHIP, MI
    ZIP 48038
  • Phone: (586) 436-3785

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NPI Details

MR. Jeffrey Charles Mundt, NP is an adult health nurse practitioner in Clinton Township, MI. MR. Jeffrey Charles Mundt, NP NPI is 1174669808. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

43475 DALCOMA DR STE 160
CLINTON TOWNSHIP, MI
ZIP 48038-591
Phone: (586) 436-3785

The NPI 1174669808 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS:J3301)
  • Injection, ketorolac tromethamine, per 15 mg (HCPCS:J1885)
  • Aspiration and/or injection of fluid large joint using ultrasound guidance (HCPCS:20611)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)

The enumeration date for this NPI number is 1/29/2007 and was last updated on 9/1/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LA2200XNurse PractitionerAdult HealthA1006121MICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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