Individual provider Active NPI

Alexea Mullis, AU.D

  • Audiologist
  • Fayetteville, GA
National Provider Identifier
1417785023
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AUD004405 Issued in GA
Practice address
1260 Highway 54 West
Suite 203
Fayetteville, GA 30214
Phone
(770) 631-1833
Fax
(770) 461-9402
NPI assigned
Jul 24, 2024
Last updated
Jul 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AUD004405 GA Primary

Addresses

Primary practice location

1260 Highway 54 West
Suite 203
Fayetteville, GA 30214

Mailing address

1260 Highway 54 W Ste 203
Fayetteville, GA 30214-4513
Phone (770) 631-1833

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241209000354 GA Practitioner - Qualified Audiologist 3971038597 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Hearing CentersGroup PAC ID 6002800570, 3 clinicians

Practice addresses (Care Compare)

1260 Hwy 54 W
Suite 102
Fayetteville, GA 30214-4513
Phone (770) 631-1833

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Services Company USA, LLC Audiologist CurrentSince Dec 1, 2025 Accepting new patients
Audiology Services Company USA, LLC CurrentSince Dec 1, 2025 Accepting new patients
American Hearing Centers Audiologist CurrentSince Jun 13, 2024 Accepting new patients

Locations

1260 Highway 54 W
Ste 102
Fayetteville, GA 30214
Phone (678) 545-1748

1260 Highway 54 W
Ste 203
Fayetteville, GA 30214
Phone (770) 460-8988

1075 Bandy Pkwy
Ste 100
Locust Grove, GA 30248
Phone (770) 996-2861

275 Upper Riverdale Rd SW
Ste A
Riverdale, GA 30274
Phone (770) 991-6755

214 Village Center Pkwy
Stockbridge, GA 30281
Phone (770) 507-0384

214 Village Center Pkwy
Ste 214
Stockbridge, GA 30281
Phone (770) 507-0384

300 Creekstone Rdg
Woodstock, GA 30188
Phone (678) 225-8838

2501 Cottontail Ln
Somerset, NJ 08873
Phone (732) 529-7120

Organizations & group practices 3

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": "1721779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1417785023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 HIGHWAY 54 W STE 203",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144513",
            "telephone_number": "770-631-1833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 HIGHWAY 54 WEST",
            "address_2": "SUITE 203",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "30214",
            "telephone_number": "770-631-1833",
            "fax_number": "770-461-9402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIS",
        "first_name": "ALEXEA",
        "name_prefix": "Dr.",
        "credential": "AU.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "GA",
            "license": "AUD004405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.