Individual provider Active NPI

Shauna Mullings

  • Pediatrics Physician
  • Saint Cloud, MN
National Provider Identifier
1487191664
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
61501 Issued in MN
Practice address
1900 Centracare Circle #1300
Centracare Clinic Pediatric/Adolescent Medicine
Saint Cloud, MN 56303-5000
Phone
(320) 654-3610
Fax
(320) 564-3647
NPI assigned
Jan 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 61501 MN Primary

Addresses

Primary practice location

1900 Centracare Circle #1300
Centracare Clinic Pediatric/Adolescent Medicine
Saint Cloud, MN 56303-5000

Mailing address

1900 Centracare Circle #1300
Centracare Clinic Pediatric/Adolescent Medicine
Saint Cloud, MN 56303-5000
Phone (320) 654-3610

Other names 1

  • Dr. Shauna Harvey Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sharvey324851@direct.centracare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20170324000180 MN Practitioner - Pediatric Medicine 8022393511 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61501MNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic CurrentSince Mar 1, 2018 Accepting new patients
Centracare Clinic Current Accepting new patients
Centracare Clinic CurrentSince Mar 1, 2018 Accepting new patients
Wayzata Children'S Clinic P.a. Pediatrics Past Accepting new patients

Locations

1900 Centracare Cir
#1300
Saint Cloud, MN 56303
Phone (320) 654-3610

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

Interoperability endpoints

  • Direct secure messaging: sharvey324851@direct.centracare.com

Organizations & group practices 4

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": "1485302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1487191664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIRCLE #1300",
            "address_2": "CENTRACARE CLINIC PEDIATRIC/ADOLESCENT MEDICINE",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-654-3610",
            "fax_number": "320-564-3647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIRCLE #1300",
            "address_2": "CENTRACARE CLINIC PEDIATRIC/ADOLESCENT MEDICINE",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-654-3610",
            "fax_number": "320-564-3647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINGS",
        "first_name": "SHAUNA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-25",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "61501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sharvey324851@direct.centracare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "sharvey324851@direct.centracare.com",
            "address_1": "1900 CentraCare Circle #1300",
            "address_2": "CentraCare Clinic Pediatric/Adolescent Medicine",
            "city": "Saint Cloud",
            "state": "MN",
            "country_code": "US",
            "postal_code": "563035000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHAUNA",
            "last_name": "HARVEY",
            "prefix": "DR.",
            "credential": "MBBS, FRCPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.