Individual provider Active NPI

Kevin Dean Mullis, P.T.

  • Physical Therapist
  • Salisbury, NC
National Provider Identifier
1124204250
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8597 Issued in NC
Practice address
1035 Lincolnton Rd Ste a
Salisbury, NC 28144-6260
Phone
(704) 603-1352
NPI assigned
Jan 18, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8597 NC Primary

Addresses

Primary practice location

1035 Lincolnton Rd Ste a
Salisbury, NC 28144-6260

Mailing address

PO Box 601791
Charlotte, NC 28260-1791

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110810000153 NC Practitioner - Physical Therapist in Private Practice 4385813252 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8597NCMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy of NC, LLC Physical Therapist CurrentSince Feb 7, 2022 Accepting new patients
Paragon Outpatient Rehabilitation Services, LLC CurrentSince Jan 3, 2023 Accepting new patients
Benchmark Physical Therapy of North Carolina LLC Physical Therapist CurrentSince Feb 7, 2022 Accepting new patients
Paragon Outpatient Rehabilitation Services, LLC Physical Therapist CurrentSince Jan 3, 2023 Accepting new patients
Bayada Home Health Care, Inc. Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

3935 Brian Jordan Pl
Ste 119
High Point, NC 27265
Phone (336) 885-0440

10020 Monroe Rd
Ste 160
Matthews, NC 28105
Phone (704) 841-0894

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1200614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1124204250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601791",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 LINCOLNTON RD STE A",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281446260",
            "telephone_number": "704-603-1352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIS",
        "first_name": "KEVIN",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-18",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "8597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.