Individual provider Active NPI

Gary John Mullen Jr., MD

  • Anesthesiology Physician
  • Greenville, NC
National Provider Identifier
1093782955
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2009-01922 Issued in NC
Practice address
2080 W Arlington Blvd Ste B
Greenville, NC 27834
Phone
(252) 752-2140
Fax
(252) 689-6502
NPI assigned
Feb 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 0101268133 VA
Anesthesiology Physician 207L00000X 52400 SC
Anesthesiology Physician 207L00000X 2009-01922 NC Primary
Anesthesiology Physician 207L00000X 88020 GA

Addresses

Primary practice location

2080 W Arlington Blvd Ste B
Greenville, NC 27834

Mailing address

4030 Wake Forest Rd Ste 349
Raleigh, NC 27609-0010
Phone (850) 261-4322

Other identifiers 4

IdentifierTypeStateIssuer
225134OtherNCMEDCOST
5913427MedicaidNC
P00794665OtherNCRAILROAD MEDICARE
156HKOtherNCBLUECROSS BLUESHIELD OF NC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100213000121 NC Practitioner - Anesthesiology 0547319139 Reassigns benefits to 1 organization
I20200416002835 VA Practitioner - Anesthesiology 0547319139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Cincinnati College of Medicine and Surgery, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Carolina Anesthesia Associates PLLCGroup PAC ID 5092720813, 691 clinicians

Practice addresses (Care Compare)

10000 Falls of Neuse Rd
Raleigh, NC 27614-7838
Phone (919) 350-8000

1900 Kildaire Farm Rd
Cary, NC 27518-6616
Phone (919) 350-8000

229 Clearfield Ave
Suite 200
Virginia Beach, VA 23462-1815
Phone (757) 312-6300

2430 Emerald PL
Suite 103
Greenville, NC 27834-5743
Phone (252) 752-2140

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
88020GAMDAnesthesiology Physician
2009-01922NCMDAnesthesiology Physician
52400SCMDAnesthesiology Physician
0101268133VAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina Anesthesia Associates, PLLC Anesthesiology CurrentSince Feb 1, 2010 Accepting new patients
MVP Anesthesia Associates, PC Anesthesiology Past Accepting new patients

Locations

2430 Emerald Pl
Ste 103
Greenville, NC 27834
Phone (252) 752-2140

2080 W Arlington Blvd
Ste B
Greenville, NC 27834
Phone (252) 752-2140

229 Clearfield Ave
Ste 200
Virginia Beach, VA 23462
Phone (757) 312-6300

1037 First Colonial Rd
Virginia Beach, VA 23454
Phone (757) 491-3535

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.

Hospital & facility affiliations 3

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": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1093782955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4030 WAKE FOREST RD STE 349",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276090010",
            "telephone_number": "850-261-4322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 W ARLINGTON BLVD STE B",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "27834",
            "telephone_number": "252-752-2140",
            "fax_number": "252-689-6502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "GARY",
        "middle_name": "JOHN",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101268133",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SC",
            "license": "52400",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "2009-01922",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "88020",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "225134",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5913427",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00794665",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD OF NC",
            "identifier": "156HK",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.