Individual provider Active NPI

Haylie Lynne Mulliniks, O.D.

  • Optometrist
  • Memphis, TN
National Provider Identifier
1265617021
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2746 Issued in TN
Practice address
6465 N Quail Hollow Rd Ste 100
Memphis, TN 38120-1448
Phone
(901) 683-7255
Fax
(901) 683-3523
NPI assigned
Dec 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 785 MS
Optometrist 152W00000X 2746 TN Primary

Addresses

Primary practice location

6465 N Quail Hollow Rd Ste 100
Memphis, TN 38120-1448

Mailing address

PO Box 1798
Dept 07-004
Memphis, TN 38101-1798
Phone (901) 683-7255

Other identifiers 2

IdentifierTypeStateIssuer
1506924MedicaidTN
00937235MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080829000186 TN Practitioner - Optometry 3870669708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1365 S Germantown Rd
Germantown, TN 38138-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
785MSMDOptometrist
2746TNMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southern College of Optometry Optometrist CurrentSince Oct 6, 2025 Accepting new patients

Locations

1245 Madison Ave
Memphis, TN 38104
Phone (901) 722-3250

Interoperability endpoints

  • Direct secure messaging: haylie.mulliniks@toyosclinic.directbygreenway.com

Organizations & group practices 1

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": "1198886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1265617021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1798",
            "address_2": "DEPT 07-004",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381011798",
            "telephone_number": "901-683-7255",
            "fax_number": "901-683-3523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6465 N QUAIL HOLLOW RD STE 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381201448",
            "telephone_number": "901-683-7255",
            "fax_number": "901-683-3523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINIKS",
        "first_name": "HAYLIE",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-29",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "785",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1506924",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00937235",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.