Individual provider Active NPI

Meagan Kathleen Mulligan, FNP

  • Family Nurse Practitioner
  • Auburn, CA
National Provider Identifier
1093071078
Registry record updated Aug 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
337067 Issued in NY
Practice address
11670 Atwood Rd
Auburn, CA 95603-9522
Phone
(530) 887-2810
NPI assigned
Apr 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 652058 NY
Registered Nurse 163W00000X 66015 HI
Registered Nurse 163W00000X 798442 CA
Family Nurse Practitioner 363LF0000X 337067 NY Primary

Addresses

Primary practice location

11670 Atwood Rd
Auburn, CA 95603-9522

Mailing address

11670 Atwood Rd
Auburn, CA 95603-9522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140717000366 CA Practitioner - Nurse Practitioner 2163665720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11670 Atwood Rd
Auburn, CA 95603-9522
Phone (530) 887-2800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
798442CAMDRegistered Nurse
66015HIMDRegistered Nurse
652058NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Chapa-de Indian Health Program, Inc. CurrentSince Jun 15, 2014 Accepting new patients

Locations

11670 Atwood Rd
Auburn, CA 95603
Phone (530) 887-2800

1350 E Main St
Grass Valley, CA 95945
Phone (530) 477-8545

Interoperability endpoints

  • Direct secure messaging: meagan.mulligan@cdih.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/AHHIAD

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438905600000",
    "number": "1093071078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11670 ATWOOD RD",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956039522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11670 ATWOOD RD",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956039522",
            "telephone_number": "530-887-2810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIGAN",
        "first_name": "MEAGAN",
        "middle_name": "KATHLEEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-04",
        "last_updated": "2015-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "652058",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "HI",
            "license": "66015",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "798442",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "337067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, CA

Sources for this page

Verify at the official NPI Registry.