Individual provider Active NPI

Christin Colavita Mulholland, CRNP

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1366959587
Registry record updated Jan 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP018335 Issued in PA
Practice address
301 W Girard Ave
Philadelphia, PA 19123-1531
Phone
(215) 685-3800
NPI assigned
Jan 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP018335 PA Primary

Addresses

Primary practice location

301 W Girard Ave
Philadelphia, PA 19123-1531

Mailing address

230 Ballytore CT
Yardley, PA 19067-5739
Phone (215) 208-9083

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180719002446 PA Practitioner - Nurse Practitioner 4880941939 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City of PhiladelphiaGroup PAC ID 6305758723, 86 clinicians

Practice addresses (Care Compare)

321 W Girard Ave
Health Care Ctr 6
Philadelphia, PA 19123-1531
Phone (215) 685-3808

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP018335PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
City of Philadelphia CurrentSince Jun 12, 2018 Accepting new patients
City of Philadelphia Current Accepting new patients
City of Philadelphia CurrentSince Jun 12, 2018 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2021 Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2021 Accepting new patients

Locations

1101 Market St
Fl 10
Philadelphia, PA 19107

321 W Girard Ave
#6
Philadelphia, PA 19123
Phone (215) 685-3803

1101 Market St
Fl 11
Philadelphia, PA 19107

4400 Haverford Ave
#4
Philadelphia, PA 19104
Phone (215) 685-7600

Organizations & group practices 6

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": "1515456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515456000000",
    "number": "1366959587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 BALLYTORE CT",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "190675739",
            "telephone_number": "215-208-9083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W GIRARD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191231531",
            "telephone_number": "215-685-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULHOLLAND",
        "first_name": "CHRISTIN",
        "middle_name": "COLAVITA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-09",
        "last_updated": "2018-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP018335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.