Individual provider Active NPI

Carleen Eleanor Mullins, RD

  • Registered Dietitian
  • Douglasville, GA
National Provider Identifier
1063271468
Registry record updated Jun 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86046811 Issued in NU
Practice address
179 Clarice Rd
Douglasville, GA 30134-4854
Phone
(678) 333-1716
NPI assigned
Mar 18, 2024
Last updated
Jun 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86046811 NU Primary

Addresses

Primary practice location

179 Clarice Rd
Douglasville, GA 30134-4854

Mailing address

179 Clarice Rd
Douglasville, GA 30134-4854
Phone (678) 333-1716

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240409001736 NC Practitioner - Registered Dietitian Or Nutrition Professional 3870931934 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Henderson County Hospital Corporation CurrentSince Apr 1, 2024 Accepting new patients
Henderson County Hospital Corporation CurrentSince Apr 1, 2024 Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients

Locations

2695 Hendersonville Rd
Ste 132
Arden, NC 28704
Phone (828) 694-8436

21 Turtle Creek Dr
Ste 100
Asheville, NC 28803
Phone (828) 435-8394

800 N Justice St
#16
Hendersonville, NC 28791
Phone (828) 694-8350

800 N Justice St
Hendersonvlle, NC 28791
Phone (828) 696-1000

Networks

  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749945600000",
    "number": "1063271468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 CLARICE RD",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301344854",
            "telephone_number": "678-333-1716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 CLARICE RD",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301344854",
            "telephone_number": "678-333-1716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "CARLEEN",
        "middle_name": "ELEANOR",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-18",
        "last_updated": "2025-06-15",
        "certification_date": "2025-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": "86046811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.