NPIMap

Individual provider Active NPI

Jo Dee Mulhollan, CRNP

  • Nurse Practitioner
  • Du Bois, PA
National Provider Identifier
1154805349
Registry record updated Nov 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP019168 Issued in PA
Practice address
621 S Main St
Du Bois, PA 15801-1413
Phone
(814) 299-7520
Fax
(814) 375-7798
NPI assigned
Sep 24, 2018
Last updated
Nov 2, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP019168 PA Primary

Addresses

Primary practice location

621 S Main St
Du Bois, PA 15801-1413

Mailing address

100 Hospital Ave
Du Bois, PA 15801-1440
Phone (814) 299-7520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181130001764 PA Practitioner - Nurse Practitioner 1658615703 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dubois Regional Medical CenterGroup PAC ID 5890689715, shared by 39 NPIs, 424 clinicians

Practice addresses (Care Compare)

123 Hospital Ave
Du Bois, PA 15801-1409
Phone (814) 371-1510

21911 Route 119
Punxsutawney, PA 15767-7922
Phone (814) 938-2062

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brookville Hospital Nurse Practitioner CurrentSince Jan 5, 2019 Accepting new patients
Dubois Regional Medical Center CurrentSince Oct 23, 2018 Accepting new patients
Dubois Regional Medical Center CurrentSince Oct 23, 2018 Accepting new patients
Brookville Hospital Nurse Practitioner CurrentSince Jan 5, 2019 Accepting new patients
Brookville Hospital CurrentSince Dec 1, 2025 Accepting new patients
Dubois Regional Medical Center Nurse Practitioner CurrentSince Jan 13, 2025 Accepting new patients

Locations

100 Hospital Rd
Brookville, PA 15825
Phone (814) 849-1408

100 Hospital Ave
Dubois, PA 15801
Phone (814) 375-2040

123 Hospital Ave
Dubois, PA 15801
Phone (814) 371-1510

145 Hospital Ave
Ste 102
Dubois, PA 15801
Phone (814) 375-6510

621 S Main St
Dubois, PA 15801
Phone (814) 299-7520

271 Railroad St
Philipsburg, PA 16866
Phone (814) 342-1872

21911 Route 119
Punxsutawney, PA 15767
Phone (814) 249-7410

Organizations & group practices 6

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 28

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1537747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541116800000",
    "number": "1154805349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL AVE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011440",
            "telephone_number": "814-299-7520",
            "fax_number": "814-375-7798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S MAIN ST",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011413",
            "telephone_number": "814-299-7520",
            "fax_number": "814-375-7798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULHOLLAN",
        "first_name": "JO",
        "middle_name": "DEE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-24",
        "last_updated": "2018-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP019168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Du Bois, PA

Sources for this page

Verify at the official NPI Registry.