Individual provider Active NPI

Kevin James Mullen, DPT, PT

  • Physical Therapist
  • Greensboro, NC
National Provider Identifier
1356132849
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P24027 Issued in NC
Practice address
801 Meadowood St
Greensboro, NC 27409-2838
Phone
(336) 560-8989
NPI assigned
May 14, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P24027 NC Primary

Addresses

Primary practice location

801 Meadowood St
Greensboro, NC 27409-2838

Mailing address

655 S Willow St Ste 128
Manchester, NH 03103-5723

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250609000964 NC Practitioner - Physical Therapist in Private Practice 4587174693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

801 Meadowood St
Greensboro, NC 27409-2838
Phone (336) 285-5456

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services, Inc. Physical Therapist CurrentSince May 19, 2025 Accepting new patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince May 19, 2025 Accepting new patients

Locations

2701 Pickett Rd
Durham, NC 27705
Phone (919) 419-4012

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1747180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1356132849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 S WILLOW ST STE 128",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031035723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MEADOWOOD ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274092838",
            "telephone_number": "336-560-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "KEVIN",
        "middle_name": "JAMES",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-14",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P24027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.