Active NPI
Jill Renae Mullen, DPT
- Physical Therapist
- Johnston, IA
National Provider Identifier
1346548864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 004670
- Practice address
- 5406 Merle Hay Rd
Johnston, IA 50131-1209 - Phone
- (515) 727-8750
- Fax
- (515) 727-8757
- NPI assigned
- Mar 8, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 004670 | IA | Primary |
Addresses
Primary practice location
5406 Merle Hay Rd
Johnston, IA 50131-1209
Mailing address
4532 Steinbeck St Unit 107
Ames, IA 50014-8158
Phone (515) 817-2255
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004670 | IA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366156800000",
"number": "1346548864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4532 STEINBECK ST UNIT 107",
"city": "AMES",
"state": "IA",
"postal_code": "500148158",
"telephone_number": "515-817-2255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5406 MERLE HAY RD",
"city": "JOHNSTON",
"state": "IA",
"postal_code": "501311209",
"telephone_number": "515-727-8750",
"fax_number": "515-727-8757"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLEN",
"first_name": "JILL",
"middle_name": "RENAE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-08",
"last_updated": "2013-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "004670",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Johnston, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.