Organization Active NPI

John R. Mulvey M.D., P.a.

  • Family Medicine Physician
  • Elkton, MD
National Provider Identifier
1093729493
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0045155 Issued in MD
Legal business name
JOHN R. MULVEY M.D., P.A.
Practice address
104 W Main St
Elkton, MD 21921-5509
Phone
(410) 996-8990
Fax
(410) 996-8912
NPI assigned
Jul 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Authorized official

Name
Cindy S Mulvey
Title
Office Manager
Phone
(410) 996-8990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X D0045155 MD Primary

Addresses

Primary practice location

104 W Main St
Elkton, MD 21921-5509

Mailing address

104 W Main St
Elkton, MD 21921-5509
Phone (410) 996-8990

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address john.mulvey@MFP-MD.direct.office.nextgen.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040408001168 MD Part B Supplier - Clinic/Group Practice 5092709535 Receives reassigned benefits from 1 practitioner
Practice locations: Elkton, MD

National Provider Directory

National Provider Directory

Locations

104 W Main St
Elkton, MD 21921
Phone (410) 996-8990

111 W High St
Ste 214
Elkton, MD 21921
Phone (310) 428-1070

104 W Main St
#1
Elkton, MD 21921
Phone (410) 996-8990

111 W High St
Ste 309
Elkton, MD 21921
Phone (410) 398-3434

Interoperability endpoints

  • Direct secure messaging: john.mulvey@mfp-md.direct.office.nextgen.com

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693353600000",
    "number": "1093729493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 W MAIN ST",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219215509",
            "telephone_number": "410-996-8990",
            "fax_number": "410-996-8912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W MAIN ST",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219215509",
            "telephone_number": "410-996-8990",
            "fax_number": "410-996-8912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN R. MULVEY M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A",
        "authorized_official_last_name": "MULVEY",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "410-996-8990"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0045155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "john.mulvey@MFP-MD.direct.office.nextgen.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "104 W Main St",
            "city": "Elkton",
            "state": "MD",
            "country_code": "US",
            "postal_code": "219215509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elkton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; 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.