Active NPI
Diane Lancaster Mullins, PA
- Physician Assistant
- Goldsboro, NC
National Provider Identifier
1093900466
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 100206
- Practice address
- 901 Beech St
Goldsboro, NC 27530-2922 - Phone
- (919) 739-8266
- Fax
- (919) 739-8656
- NPI assigned
- Sep 10, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 100206 | NC | Primary |
Addresses
Primary practice location
901 Beech St
Goldsboro, NC 27530-2922
Mailing address
PO Box 1798
Goldsboro, NC 27533-1798
Phone (919) 739-8266
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100206 | NC | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189382400000",
"number": "1093900466",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1798",
"city": "GOLDSBORO",
"state": "NC",
"postal_code": "275331798",
"telephone_number": "919-739-8266",
"fax_number": "919-739-8656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 BEECH ST",
"city": "GOLDSBORO",
"state": "NC",
"postal_code": "275302922",
"telephone_number": "919-739-8266",
"fax_number": "919-739-8656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLINS",
"first_name": "DIANE",
"middle_name": "LANCASTER",
"name_prefix": "Ms.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-10",
"last_updated": "2007-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "100206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goldsboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.