Individual provider Active NPI

Jalina Mueller

  • General Practice Physician
  • Lebanon, OR
National Provider Identifier
1013363928
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
0070179 Issued in CO
Practice address
200 Mullins Dr
Lebanon, OR 97355-3983
Phone
(541) 908-4101
NPI assigned
May 10, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Physician 208D00000X 0070179 CO Primary

Addresses

Primary practice location

200 Mullins Dr
Lebanon, OR 97355-3983

Mailing address

200 Mullins Dr
Lebanon, OR 97355-3983
Phone (541) 908-4101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240118004349 KY Practitioner - General PracticePractitioner - General Surgery 3375995954 Reassigns benefits to 2 organizations
I20251204002348 TN Practitioner - General Practice 3375995954 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Western Un of HLTH Sciences, Col of Podiatric Med, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vohra Post Acute Care Physicians of the East PAGroup PAC ID 5496981243, 56 clinicians

Practice addresses (Care Compare)

10200 Forest Green Blvd
Suite 112
Louisville, KY 40223-5167
Phone (954) 399-4673

409 Park Ave
Adamsville, TN 38310-2461
Phone (731) 632-3301

600 Shawanee Rd
Harrogate, TN 37752-8305
Phone (423) 869-5376

902 Buchanan Rd
New Tazewell, TN 37825-7410
Phone (423) 626-8215

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1156
Removal of skin lesions21
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0070179COMDGeneral Practice Physician
6387TNMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vohra Post Acute Care Physicians of the East, PA CurrentSince Dec 4, 2023 Accepting new patients
Wound Management Specialists, LLC CurrentSince Jan 26, 2026 Accepting new patients

Locations

3601 SW 160th Ave
Ste 250
Miramar, FL 33027
Phone (305) 866-9951

1680 Campbell Ln
Ste 109
Bowling Green, KY 42104
Phone (629) 240-5023

10200 Forest Green Blvd
Ste 112
Louisville, KY 40223
Phone (502) 214-5343

434 Katherine Dr
Flowood, MS 39232
Phone (769) 216-3346

778 Liberty Rd
Flowood, MS 39232
Phone (601) 914-9620

409 Park Ave
Adamsville, TN 38310
Phone (731) 541-4923

725 Cool Springs Blvd
Ste 600
Franklin, TN 37067
Phone (888) 250-6394

6019 Walnut Grove Rd
Memphis, TN 38120
Phone (901) 226-3190

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1462838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1013363928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MULLINS DR",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973553983",
            "telephone_number": "541-908-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MULLINS DR",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973553983",
            "telephone_number": "541-908-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUELLER",
        "first_name": "JALINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-10",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CO",
            "license": "0070179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, OR

Sources for this page

Verify at the official NPI Registry.