Jeremy Mullavey, ARNP

Primary specialty

Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X

License

AP61577243 Issued in WA

Practice address

62 W 7TH Ave Ste 110
Spokane, WA 99204-2321

Phone

(509) 456-0262

NPI assigned

Jul 5, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Nurse Practitioner

Education

University of Alabama School of Medicine, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services-WaGroup PAC ID 7911069703, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Prov Sacred HRT Med Ctr & Childs Hosp. Hospital, Spokane, WA, CCN 500054
• Kadlec Regional Medical Center Hospital, Richland, WA, CCN 500058
• Providence St Mary Medical Center Hospital, Walla Walla, WA, CCN 500002
• Providence Mount Carmel Hospital Hospital, Colville, WA, CCN 501326

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Providence Health & Services-Wa

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Spokane, WA
  • NPI 1538311287
  Medicare reassignment Care Compare group NPD
• Kadlec Regional Medical Center

  • General Acute Care Hospital
  • Richland, WA
  • NPI 1972507580
  NPD (past)

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

• Kadlec Regional Medical Center

  • General Acute Care Hospital
  • Richland, WA
  • NPI 1972507580
  Care Compare affiliation
• Providence Health & Services - Wa

  • General Acute Care Hospital
  • Spokane, WA
  • NPI 1144471715
  Care Compare affiliation
• Providence Health & Services - Washington

  • Critical Access Hospital
  • Colville, WA
  • NPI 1003067679
  Care Compare affiliation
• Providence Health & Services - Washington

  • General Acute Care Hospital
  • Walla Walla, WA
  • NPI 1386895886
  Care Compare affiliation

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

{
    "created_epoch": "1720137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720137600000",
    "number": "1245076553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4308 E 41ST AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992231279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 W 7TH AVE STE 110",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042321",
            "telephone_number": "509-456-0262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 W 8th Ave",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992042307",
            "country_code": "US",
            "telephone_number": "509-474-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLAVEY",
        "first_name": "JEREMY",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-05",
        "last_updated": "2024-07-05",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "WA",
            "license": "AP61577243",
            "primary": false
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "WA",
            "license": "AP61577243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrien Mulawka, CNP
• Brett Steven Mulawka, M.D.
• Curtis J Mulder, M.A.
• Elizabeth Anne Mulherron-Cayton, PSYD, LP
• Kelleen Mullaney, MD
• Barbara Clare Mullen, L.AC
• Jennifer Mullen
• Ashley Mullenbach, OTR/L
• Ashley Mullenix
• Tiffany Ann Mullin I, CP60969079

• Critical Care Medicine Nurse Practitioner in Spokane, WA
• Providers in Spokane, WA by specialty
• Critical Care Medicine Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.