Individual provider Active NPI

Jennifer Leigh Mullendore, MD

  • Family Medicine Physician
  • Asheville, NC
National Provider Identifier
1417991845
Registry record updated Jul 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
200600657 Issued in NC
Practice address
40 Coxe Ave
Asheville, NC 28801-3308
Phone
(828) 250-5000
Fax
(828) 250-6165
NPI assigned
Jun 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 200600657 NC Primary
General Practice Physician 208D00000X 2006-00657 NC

Addresses

Primary practice location

40 Coxe Ave
Asheville, NC 28801-3308

Mailing address

PO Box 7407
Attention: Accounting Unit
Asheville, NC 28802-7407
Phone (828) 250-5000

Other identifiers 2

IdentifierTypeStateIssuer
190513OtherNCMEDCOST
5904408MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061010000138 NC Practitioner - Family Practice 7012913387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Georgetown University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

40 Coxe Ave
Asheville, NC 28801-3308
Phone (828) 250-5218

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200600657NCMDFamily Medicine Physician
2006-00657NCMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Buncombe Office of Accountant CurrentSince Jul 16, 2007 Accepting new patients
County of Buncombe CurrentSince Jul 16, 2007 Accepting new patients
Buncombe County Department of Social Services Past Accepting new patients

Locations

40 Coxe Ave
Asheville, NC 28801
Phone (828) 250-5000

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373587200000",
    "number": "1417991845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7407",
            "address_2": "ATTENTION: ACCOUNTING UNIT",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288027407",
            "telephone_number": "828-250-5000",
            "fax_number": "828-250-6165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 COXE AVE",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288013308",
            "telephone_number": "828-250-5000",
            "fax_number": "828-250-6165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLENDORE",
        "first_name": "JENNIFER",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2013-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200600657",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NC",
            "license": "2006-00657",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "190513",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5904408",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheville, NC

Sources for this page

Verify at the official NPI Registry.