Individual provider Active NPI

Mary Kate Mulhall, DNP/FNP-BC

  • Family Nurse Practitioner
  • Augusta, GA
National Provider Identifier
1457862286
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN210234 Issued in GA
Practice address
1417 Pendleton Rd
Augusta, GA 30904-4837
Phone
(706) 738-9824
NPI assigned
Oct 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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 RN210234 GA
Family Nurse Practitioner 363LF0000X RN210234 GA Primary

Addresses

Primary practice location

1417 Pendleton Rd
Augusta, GA 30904-4837

Mailing address

1417 Pendleton Rd
Augusta, GA 30904-4837

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180720001251 GA Practitioner - Nurse Practitioner 3375890494 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Medical College of Georgia School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

1220 W Wheeler Pkwy
Augusta, GA 30909-6625
Phone (706) 721-8623

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Au Medical Associates Inc CurrentSince Apr 1, 2018 Accepting new patients
Wellstar Medical Group, LLC Family Medicine Current Accepting new patients
Au Medical Associates Inc CurrentSince Apr 1, 2018 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Apr 1, 2024 Accepting new patients
Wellstar Cardiovascular Medicine, LLC Past Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

1120 15th St
Ste BI1056
Augusta, GA 30912
Phone (706) 721-2785

1220 W Wheeler Pkwy
Augusta, GA 30909
Phone (706) 721-2741

1499 Walton Way
Ste 1400
Augusta, GA 30901
Phone (706) 721-4951

1417 Pendleton Rd
Augusta, GA 30904
Phone (706) 738-9824

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

Organizations & group practices 5

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": "1508371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1457862286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 PENDLETON RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309044837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 PENDLETON RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309044837",
            "telephone_number": "706-738-9824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULHALL",
        "first_name": "MARY",
        "middle_name": "KATE",
        "name_prefix": "Dr.",
        "credential": "DNP/FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-19",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "RN210234",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN210234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.