Individual provider Active NPI

Ralph H Mullins, OD

  • Optometrist
  • Cookeville, TN
National Provider Identifier
1366425605
Registry record updated Dec 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TN635 Issued in TN
Practice address
585 E 10TH St
Cookeville, TN 38501-1807
Phone
(931) 526-6711
Fax
(931) 526-6712
NPI assigned
Nov 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TN635 TN Primary
Corneal and Contact Management Optometrist 152WC0802X TN635 TN
Occupational Vision Optometrist 152WX0102X TN635 TN

Addresses

Primary practice location

585 E 10TH St
Cookeville, TN 38501-1807

Mailing address

585 E 10TH St
Cookeville, TN 38501-1807
Phone (931) 526-6711

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
I20070912000207 TN Practitioner - Optometry 5799878302 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mullins Vision Associates,PLLCGroup PAC ID 3870686488, 4 clinicians

Practice addresses (Care Compare)

585 E 10TH St
Cookeville, TN 38501-1807
Phone (931) 526-6711

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery38

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TN635TNMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mullins Vision Associates,PLLC Optometrist CurrentSince Jan 1, 2007 Accepting new patients
Mullins Vision South, PLLC Optometrist CurrentSince Mar 1, 2020 Accepting new patients

Locations

585 E 10th St
Cookeville, TN 38501
Phone (931) 526-6711

126 E Bockman Way
Sparta, TN 38583
Phone (931) 836-2235

Interoperability endpoints

  • Direct secure messaging: drralph@mullinsvision.eyefinity-direct.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356480000000",
    "number": "1366425605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 E 10TH ST",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385011807",
            "telephone_number": "931-526-6711",
            "fax_number": "931-526-6712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 E 10TH ST",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385011807",
            "telephone_number": "931-526-6711",
            "fax_number": "931-526-6712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "RALPH",
        "middle_name": "H",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2012-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "TN635",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TN",
            "license": "TN635",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "TN",
            "license": "TN635",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

Verify at the official NPI Registry.