Active NPI
Jennifer Lynn Mullins, PHARMD
- Pharmacist
- Roanoke, VA
National Provider Identifier
1114598406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202207552
- Practice address
- 1345 Plantation Rd NE
Roanoke, VA 24012-5712 - Phone
- (833) 510-4357
- NPI assigned
- Jul 7, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202207552 | VA | Primary |
Addresses
Primary practice location
1345 Plantation Rd NE
Roanoke, VA 24012-5712
Mailing address
615 Elsinore PL Ste 200
Cincinnati, OH 45202-1457
Phone (513) 834-7063
Other practice location 1
72 Kingston Dr
Daleville, VA 24083-2574
Phone (540) 992-1291
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202207552 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kroger Limited Partnership I | Past | Accepting new patients | |
| Kroger Limited Partnership I | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Daleville, VA
- NPI 1154355923
-
- Community/Retail Pharmacy
- Newport, KY
- NPI 1104791078
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649721600000",
"number": "1114598406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 ELSINORE PL STE 200",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452021457",
"telephone_number": "513-834-7063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1345 PLANTATION RD NE",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240125712",
"telephone_number": "833-510-4357"
}
],
"practiceLocations": [
{
"address_1": "72 Kingston Dr",
"address_purpose": "LOCATION",
"city": "Daleville",
"state": "VA",
"postal_code": "240832574",
"country_code": "US",
"telephone_number": "540-992-1291",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MULLINS",
"first_name": "JENNIFER",
"middle_name": "LYNN",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-07-07",
"last_updated": "2022-04-12",
"certification_date": "2022-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202207552",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Roanoke, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.