Ronald J Mullis, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

C7126 Issued in AR

Practice address

3 E Appleby Rd Ste 401
Fayetteville, AR 72703-3163

Phone

(479) 404-2500

Fax

(479) 404-2501

NPI assigned

Jul 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Jay Mullis Other name

Medicare fee-for-service enrollment

Enrolled in AR

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

Specialty

General Surgery

Education

University of Arkansas College of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Washington Regional Medical SystemGroup PAC ID 8820995434, 238 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Washington Regional Medical Center Hospital, Fayetteville, AR, CCN 040004

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rmullis23125@washingtonregional.direct-ci.com

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.

• Washington Regional Medical System

  dba Washington Regional Family Clinic - Springdale

  • Family Medicine Physician
  • Springdale, AR
  • NPI 1326376419
  Medicare reassignment Care Compare group NPD
• Ozark Surgical Associates

  • Surgery Physician
  • Fayetteville, AR
  • NPI 1013905587
  Medicare reassignment NPD
• Washington Regional Medical System

  dba Washington Regional Family Clinic - Farmington

  • Family Medicine Physician
  • Farmington, AR
  • NPI 1275839011
  NPD
• Washington Regional Medical System

  dba Harber Internal Medicine - Washington Regional

  • Internal Medicine Physician
  • Springdale, AR
  • NPI 1649685454
  NPD
• Washington Regional Medical System

  dba Washington Regional Hospital Medicine Group

  • Hospitalist Physician
  • Fayetteville, AR
  • NPI 1306801485
  NPD (past)

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

• Washington Regional Medical Center

  • General Acute Care Hospital
  • Fayetteville, AR
  • NPI 1083609150
  Care Compare affiliation

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1093729246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 E APPLEBY RD STE 401",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727033163",
            "telephone_number": "479-404-2500",
            "fax_number": "479-404-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 E APPLEBY RD STE 401",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727033163",
            "telephone_number": "479-404-2500",
            "fax_number": "479-404-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIS",
        "first_name": "RONALD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AR",
            "license": "C7126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113060001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "247267",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA INDIVIDUAL #",
            "identifier": "4347758",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203560800",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "12445000000",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100077770A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAY",
            "last_name": "MULLIS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jacklynn Marie Mullen
• Malorie Dawn Mullens
• Samuel Zachary Mullinax
• Lona Mardell Mullins, LCSW
• Markese Aveon Mullins
• Evan Munro
• Steven Edward Munson, M.D. 5/24/2009
• Lauren Murphy
• Lora Murphy, CCC-SLP
• Meghan Murphy, PH.D.

• Surgery Physician in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Surgery Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.