Active NPI
Raymond David Mulligan, PSYD, MBA
- Psychologist
- Kiawah Island, SC
National Provider Identifier
1265765994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1356
- Practice address
- 431 Snowy Egret Lane
Kiawah Island, SC 29455 - Phone
- (610) 216-4736
- Fax
- (610) 867-5003
- NPI assigned
- Sep 14, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1356 | SC | Primary |
| Psychologist | 103T00000X | PS016669 | PA |
Addresses
Primary practice location
431 Snowy Egret Lane
Kiawah Island, SC 29455
Mailing address
431 Snowy Egret Lane
R D Mulligan, LLC
Kiawah Island, SC 29455
Phone (610) 216-4736
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12013691 | Other | PA | CAQH |
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)
- Enrolled
- Credentials
- Master of Business Administration
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS016669 | PA | MD | Psychologist |
| 1356 | SC | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440979200000",
"number": "1265765994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "431 SNOWY EGRET LANE",
"address_2": "R D MULLIGAN, LLC",
"city": "KIAWAH ISLAND",
"state": "SC",
"postal_code": "29455",
"telephone_number": "610-216-4736",
"fax_number": "610-867-5003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "431 SNOWY EGRET LANE",
"city": "KIAWAH ISLAND",
"state": "SC",
"postal_code": "29455",
"telephone_number": "610-216-4736",
"fax_number": "610-867-5003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLIGAN",
"first_name": "RAYMOND",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "PSYD, MBA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-09-14",
"last_updated": "2015-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "SC",
"license": "1356",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS016669",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "12013691",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kiawah Island, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.