NPIMap

Individual provider Active NPI

Merrylee Ann Mullinax, FNP-C

  • Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1013999879
Registry record updated Dec 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
026671622 Issued in SC
Practice address
3523 Pelham Rd
Suite C
Greenville, SC 29615-4191
Phone
(864) 306-0966
Fax
(864) 306-2544
NPI assigned
Nov 17, 2005
Last updated
Dec 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 026671622 SC Primary

Addresses

Primary practice location

3523 Pelham Rd
Suite C
Greenville, SC 29615-4191

Mailing address

P.O. Box 14611
Greenville, SC 29610-4611
Phone (864) 306-0966

Other identifiers 1

IdentifierTypeStateIssuer
NP0091MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100614000046 SC Practitioner - Nurse Practitioner 5294865580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Carolina School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Geriatrics, Inc.Group PAC ID 0941271035, 11 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

Greenville, SC 29615
Phone (864) 306-0966

1305 Boiling Springs Rd
Greer, SC 29650-4139
Phone (864) 458-7566

1560 Thornblade Blvd
Greer, SC 29650-4448
Phone (864) 968-1277

190 River Park Dr
Little River, SC 29566-6844
Phone (843) 734-1457

414 Summit Dr
Greenville, SC 29609-4821
Phone (864) 271-7562

810 E Butler Rd
Greenville, SC 29607-5842
Phone (864) 627-0803

850 E Butler Rd
Greenville, SC 29607-5842
Phone (864) 675-6421

PO Box
Suite 14611
Greenville, SC 29610-4611

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.74 of 100Reported as group
Quality
83.33
Improvement activities
40
Cost
51.35

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
026671622SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Geriatrics, Inc. CurrentSince Sep 1, 2001 Accepting new patients

Locations

3523 Pelham Rd
Ste C
Greenville, SC 29615
Phone (864) 306-0966

850 E Butler Rd
Greenville, SC 29607
Phone (864) 306-0966

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 47

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1013999879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 14611",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296104611",
            "telephone_number": "864-306-0966",
            "fax_number": "864-306-2544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3523 PELHAM RD",
            "address_2": "SUITE C",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154191",
            "telephone_number": "864-306-0966",
            "fax_number": "864-306-2544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINAX",
        "first_name": "MERRYLEE",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-17",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "026671622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0091",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.