Active NPI
Erica Mullally
- Nutritionist
- Kittery, ME
National Provider Identifier
1174284160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- Practice address
- 3 Lewis Ave
Kittery, ME 03904-1441 - Phone
- (508) 440-9426
- NPI assigned
- Jan 3, 2022
- Last updated
- Jan 3, 2022
- 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 |
|---|---|---|---|---|
| Nutritionist | 133N00000X | NU | Primary |
Addresses
Primary practice location
3 Lewis Ave
Kittery, ME 03904-1441
Mailing address
3 Lewis Ave
Kittery, ME 03904-1441
Phone (508) 440-9426
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0510-2022 | Medicaid | NH | |
| 0510-2022 | Medicaid | ME | |
| 0510-2022 | Medicaid | MA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641168000000",
"number": "1174284160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 LEWIS AVE",
"city": "KITTERY",
"state": "ME",
"postal_code": "039041441",
"telephone_number": "508-440-9426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 LEWIS AVE",
"city": "KITTERY",
"state": "ME",
"postal_code": "039041441",
"telephone_number": "508-440-9426"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLALLY",
"first_name": "ERICA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-01-03",
"last_updated": "2022-01-03",
"certification_date": "2022-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0510-2022",
"state": "NH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0510-2022",
"state": "ME"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0510-2022",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kittery, ME
- Tammy Jo McCauley-Masse, BSN RN CCM
- Alice Gansecki Meattey, LIC AC LICENSED ACUP
- Maria de Los Angeles Melendez
- Heather Moher, D.O.
- Thurston Olaf Monson II, M.D.
- Thea Emogene Murphy, MSN, FNP-C
- Heidi A Nadeau, LMT
- Naval Health Clinic New England (Dod Portsmouth Kittery Pharmacy)
- New England Telemedicine PA (New England Telemedicine)
- New England Telemedicine PA (Paramount Medical Supply)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.