Garrick Brent Mullis, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

200400719 Issued in NC

Practice address

1028 Lee Ann Dr NE
Suite 200
Concord, NC 28025-2911

Phone

(704) 782-1892

NPI assigned

May 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Specialty

Emergency Medicine

Education

Wake Forest University School of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolina Medicorp Enterprises LLCGroup PAC ID 0648174904, 184 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gmullis500435@carolinashealthcaresystem.direct-ci.com
• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
• Direct secure messaging: gmullis919959@direct.novanthealth.org

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.

• Carolina Medicorp Enterprises, LLC

  • Urgent Care Clinic/Center
  • Charlotte, NC
  • NPI 1760950646
  Medicare reassignment Care Compare group NPD
• Emergency Medicine Physicians of Mecklenburg County, PLLC

  • Emergency Medicine Physician
  • Charlotte, NC
  • NPI 1912232182
  Medicare reassignment NPD
• The Carolinas Emergency Group, PLLC

  • Emergency Medicine Physician
  • Dunn, NC
  • NPI 1477508836
  Medicare reassignment NPD
• Carolina Medicorp Enterprises, LLC

  • Urgent Care Clinic/Center
  • Asheville, NC
  • NPI 1235014796
  NPD
• Western Carolina Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Albemarle, NC
  • NPI 1134391758
  NPD (past)

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384992000000",
    "number": "1427006865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1028 LEE ANN DR NE",
            "address_2": "SUITE 200",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252911",
            "telephone_number": "704-782-1892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 LEE ANN DR NE",
            "address_2": "SUITE 200",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252911",
            "telephone_number": "704-782-1892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIS",
        "first_name": "GARRICK",
        "middle_name": "BRENT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2013-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "200400719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "232279",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "136YH",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89136YH",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jibri Hashim Muhammad, DDS
• Justin Ahmad Muhammad
• Candace Muir
• Kristina Mullen, PA-C
• Kelly Ann Mullican, PHARMD
• Kevin Mumpasi
• Munaf Concord DMD PLLC
• Munaf Concord DMD PLLC
• Margaret Mundt
• Christine Munoz, R.D., L.D.N.

• Emergency Medicine Physician in Concord, NC
• Providers in Concord, NC by specialty
• Emergency Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2013; 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.
• 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.