Individual provider Active NPI

Ashley Lydia Mullican, APRN, NP-C

  • Family Nurse Practitioner
  • Lawrenceville, GA
National Provider Identifier
1013426675
Registry record updated Nov 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F06171471 Issued in GA
Practice address
1925 Old Peachtree Rd NE
Lawrenceville, GA 30043-2822
Phone
(770) 339-5999
NPI assigned
Sep 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F06171471 GA Primary

Addresses

Primary practice location

1925 Old Peachtree Rd NE
Lawrenceville, GA 30043-2822

Mailing address

136 River Mist Cir
Jefferson, GA 30549-8621
Phone (770) 540-8304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180713001049 GA Practitioner - Nurse Practitioner 1052667516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Norvin Ona, DO, PCGroup PAC ID 6103811435, 3 clinicians

Practice addresses (Care Compare)

1925 Old Peachtree Rd NE
Lawrenceville, GA 30043-2822
Phone (770) 339-5999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F06171471GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Norvin Ona, DO, PC CurrentSince Apr 4, 2018 Accepting new patients

Locations

1925 Old Peachtree Rd NE
Lawrenceville, GA 30043
Phone (770) 339-5999

Organizations & group practices 1

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": "1506470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541462400000",
    "number": "1013426675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 RIVER MIST CIR",
            "city": "JEFFERSON",
            "state": "GA",
            "postal_code": "305498621",
            "telephone_number": "770-540-8304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 OLD PEACHTREE RD NE",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300432822",
            "telephone_number": "770-339-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLICAN",
        "first_name": "ASHLEY",
        "middle_name": "LYDIA",
        "credential": "APRN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-27",
        "last_updated": "2018-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "F06171471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.