NPIMap

Individual provider Active NPI

Suzanne Green Mullikin, APRN, FNP-BC

  • Family Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1245912542
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
27719 Issued in SC
Practice address
52 Bear Dr
Greenville, SC 29605-4458
Phone
(864) 655-4005
NPI assigned
Aug 4, 2023
Last updated
May 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 27719 SC Primary

Addresses

Primary practice location

52 Bear Dr
Greenville, SC 29605-4458

Mailing address

142 Shallowford Rd
Greenville, SC 29607-3312
Phone (803) 468-2632

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20250113000378 SC Practitioner - Nurse Practitioner 3779011283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifestyle Neurology LLCGroup PAC ID 6800106469, 4 clinicians

Practice addresses (Care Compare)

52 Bear Dr
Greenville, SC 29605-4458
Phone (864) 655-4005

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lifestyle Neurology, LLC CurrentSince Nov 1, 2024 Accepting new patients
Premier Neurology, PC Past Accepting new patients

Locations

52 Bear Dr
Greenville, SC 29605
Phone (864) 295-2131

420 The Pkwy
Ste N
Greer, SC 29650
Phone (703) 509-3310

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GJDADD/Endpoint/GJDADD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 47

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

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1691107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1245912542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 SHALLOWFORD RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073312",
            "telephone_number": "803-468-2632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 BEAR DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054458",
            "telephone_number": "864-655-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIKIN",
        "first_name": "SUZANNE",
        "middle_name": "GREEN",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-04",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "27719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.