Active NPI
Anne Mullaly
- Pharmacist
- Johnston, RI
National Provider Identifier
1073187332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RX03948
- Practice address
- 1400 Hartford Ave
Johnston, RI 02919-3204 - Phone
- (401) 861-0310
- NPI assigned
- May 19, 2021
- Last updated
- May 19, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RX03948 | RI | Primary |
Addresses
Primary practice location
1400 Hartford Ave
Johnston, RI 02919-3204
Mailing address
1400 Hartford Ave
Johnston, RI 02919-3204
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RPH03948 | Other | RI | RI LICENCE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | annegx4c@aol.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RX03948 | RI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rhode Island CVS Pharmacy LLC | Past | Accepting new patients | |
| Rhode Island CVS Pharmacy, L.L.C. | Past | Accepting new patients |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621382400000",
"number": "1073187332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 HARTFORD AVE",
"city": "JOHNSTON",
"state": "RI",
"postal_code": "029193204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 HARTFORD AVE",
"city": "JOHNSTON",
"state": "RI",
"postal_code": "029193204",
"telephone_number": "401-861-0310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLALY",
"first_name": "ANNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-19",
"last_updated": "2021-05-19",
"certification_date": "2021-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "RI",
"license": "RX03948",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RI LICENCE",
"identifier": "RPH03948",
"state": "RI"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "annegx4c@aol.com",
"affiliation": "N",
"address_1": "1400 Hartford Ave",
"city": "Johnston",
"state": "RI",
"country_code": "US",
"postal_code": "029193204",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Johnston, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.