Individual provider Active NPI

Ryan James Mulligan, MD, PHD

  • Student in an Organized Health Care Education/Training Program
  • Charlottesville, VA
National Provider Identifier
1023958352
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1215 Lee St Box 800904
Charlottesville, VA 22908-0816
Phone
(434) 924-1946
Fax
(434) 924-9492
NPI assigned
Mar 30, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1215 Lee St Box 800904
Charlottesville, VA 22908-0816

Mailing address

1215 Lee St
Box 800904
Charlottesville, VA 22908-0816
Phone (434) 924-1946

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20260624000520 VA Order and Referring Only - PathologyPractitioner - Pathology 6709359524

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1774828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1023958352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 LEE ST",
            "address_2": "BOX 800904",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080816",
            "telephone_number": "434-924-1946",
            "fax_number": "434-924-9492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LEE ST BOX 800904",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080816",
            "telephone_number": "434-924-1946",
            "fax_number": "434-924-9492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIGAN",
        "first_name": "RYAN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-30",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.