Icie Hutcheson Mullis, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

24046 Issued in SC

Practice address

1333 Taylor St
Columbia, SC 29201-2923

Phone

(803) 296-5914

Fax

(803) 296-5902

NPI assigned

Jul 10, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: imullis253307@direct.ghs.myhfn.org
• FHIR API: https://api.platform.athenahealth.com/17912/brand/1/csg/1/fhir/r4

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.

• Prisma Health University Medical Group

  • Family Medicine Physician
  • Greenville, SC
  • NPI 1295763217
  Medicare reassignment NPD
• The Practice

  • Family Medicine Physician
  • Columbia, SC
  • NPI 1558852855
  Medicare reassignment NPD
• Prisma Health University Medical Group

  • Gynecology Physician
  • Greer, SC
  • NPI 1003619313
  NPD

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

{
    "created_epoch": "1594339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1114545647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-695-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 TAYLOR ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012923",
            "telephone_number": "803-296-5914",
            "fax_number": "803-296-5902"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Assembly St",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292013938",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1235 Mullis Road",
            "address_purpose": "LOCATION",
            "city": "Blythewood",
            "state": "SC",
            "postal_code": "29016",
            "country_code": "US",
            "telephone_number": "803-331-6613",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1910 Gregg St",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292012618",
            "country_code": "US",
            "telephone_number": "803-779-5959",
            "fax_number": "803-799-9353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLIS",
        "first_name": "ICIE",
        "middle_name": "HUTCHESON",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-10",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "24046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1114545647",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN",
            "identifier": "24046",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Mullins
• Darren Eugene Mullins, M.D.
• Elizabeth M Mullins
• Mary Robin Mullins, RD
• Melissa M Mullins, LPC
• Laura Mullis, APRN
• Lennie Schlager Mullis, LPCI
• Justin Andrew Mullner, MD
• Multidisciplinary Therapy
• Multidisciplinary Therapy

• Family Nurse Practitioner in Columbia, SC
• Providers in Columbia, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.