Jonathan T Mullis, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

005099 Issued in GA

Practice address

1062 Forsyth St Ste 2D
Macon, GA 31201-8639

Phone

(478) 633-8391

NPI assigned

Jul 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jmullis433178@carolinashealthcaresystem.direct-ci.com

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.

• Health Services of Central Georgia, Inc

  dba Atrium Health Navicent Medical Group

  • Multi-Specialty Clinic/Center
  • Macon, GA
  • NPI 1184679482
  Medicare reassignment
• Forsyth Street Orthopaedic Surgery and Rehabilitation Center

  • Orthopaedic Surgery Physician
  • Macon, GA
  • NPI 1215947858
  NPD (past)
• Macon Orthopaedic & Hand Center, PA

  dba OrthoGeorgia

  • Orthopaedic Surgery Physician
  • Macon, GA
  • NPI 1356489850

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1396945135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1062 FORSYTH ST STE 2D",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312018639",
            "telephone_number": "478-633-8391",
            "fax_number": "478-633-8395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1062 FORSYTH ST STE 2D",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312018639",
            "telephone_number": "478-633-8391"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3708 Northside Dr",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312102404",
            "country_code": "US",
            "telephone_number": "478-745-4206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLIS",
        "first_name": "JONATHAN",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-19",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "005099",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "005099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Mullen
• Mark Mullinax, PHARM.D
• Athena Jmullins Mullins, PA-AA
• Ashley Souza Mullis, NP
• Earl Nicholas Mullis Jr., M.D.
• Joshua Mullis, NP-C
• Lori Beecher Mullis, FNP-C
• Maegan Griffin Mullis, FNP-C
• Aliesha Mumford
• Rana K Munna, M.D.

• Physician Assistant in Macon, GA
• Providers in Macon, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.