Elizabeth Rae McMullen, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

10001214A Issued in IN

Practice address

1500 W Oak St Ste 500
Zionsville, IN 46077-1852

Phone

(317) 798-3708

Fax

(317) 691-8101

NPI assigned

Sep 13, 2010

Last updated

Jul 20, 2015By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Meridian Medical Group PC

  • Gastroenterology Physician
  • Indianapolis, IN
  • NPI 1154458578
  NPD (past)

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

{
    "created_epoch": "1284336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437350400000",
    "number": "1083921928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 RONALD REAGAN PKWY STE 347",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461236914",
            "telephone_number": "317-217-2100",
            "fax_number": "317-217-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W OAK ST STE 500",
            "city": "ZIONSVILLE",
            "state": "IN",
            "postal_code": "460771852",
            "telephone_number": "317-798-3708",
            "fax_number": "317-691-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMULLEN",
        "first_name": "ELIZABETH",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-13",
        "last_updated": "2015-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001214A",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10001214A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa A McHenry, DDS,MSD
• Michael P McKenna, MD
• Tiffany McKinley
• Jill Ellen McKinney, LMHC
• Jennifer Ann McMahon, BCBA
• Meadows Outpatient Center Indiana LLC
• Medical Technologies Midwest Inc
• Jim Gus Megremis, MD
• Meijer Stores Limited Partnership (Meijer Pharmacy #152)
• Memory Compass LLC (The Memory Compass)

• Medical Physician Assistant in Zionsville, IN
• Providers in Zionsville, IN by specialty
• Medical Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; 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.