Jeri Ann Mullan, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

103401 Issued in MN

Practice address

2400 W 64TH St
Minneapolis, MN 55423-1001

Phone

(612) 798-8341

Fax

(612) 728-5301

NPI assigned

Mar 30, 2007

Last updated

Jun 16, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Fraser

  • Rehabilitation Clinic/Center
  • Richfield, MN
  • NPI 1063568574
  NPD (past)
• Fraser Child and Family Center

  • Adolescent and Children Mental Health Clinic/Center
  • Minneapolis, MN
  • NPI 1609922194
  NPD (past)

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1023138229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "952 EDMUND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551042622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 W 64TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554231001",
            "telephone_number": "612-798-8341",
            "fax_number": "612-728-5301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6328 Penn Ave S",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554231139",
            "country_code": "US",
            "telephone_number": "612-861-1688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLAN",
        "first_name": "JERI",
        "middle_name": "ANN",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "103401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA DEPARTMENT OF HEALTH",
            "identifier": "103401",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Ann Mulera
• Courtney Mulhern
• Kaitlyn Mulhern, MD
• Lawrence G Mulhern, MD
• Kimberly Mulholland, COMT, OSA
• John Charles Mullan, MD
• Kylie Karen Mullaney, DDS
• Sally A Mullany, M.D.
• Christopher L Mullen
• Grace Mullen

• Occupational Therapist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.