Jennifer Mullican, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10951 Issued in TX

Practice address

1301 Summer Lee Dr
Rockwall, TX 75032-5452

Phone

(972) 771-8111

NPI assigned

Nov 9, 2016

Last updated

Nov 9, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

VMD Primary Providers of South Central Texas PLLCGroup PAC ID 7911337472, 27 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: jennifer.mullican.1@13711.direct.athenahealth.com

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.

• VMD Primary Providers of South Central Texas PLLC

  dba Village Medical

  • Family Medicine Physician
  • Austin, TX
  • NPI 1790318566
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1478649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478649600000",
    "number": "1497297386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19212 LUEDTKE LN",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786605022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 SUMMER LEE DR",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750325452",
            "telephone_number": "972-771-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLICAN",
        "first_name": "JENNIFER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-09",
        "last_updated": "2016-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA10951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leigh Anne Mota
• Ross Moulder, OD
• Victor Alonzo Moya, DPT
• Atupele Mshana, LPC - ASSOCIATE
• Charlette Rene Mueller, RN
• Endrit Mulliqi
• Erica Marie Mumford, PA
• James G Muns, MD
• Carrie Minette Murdick, M.S CCC-SLP
• Danielle Dutcher Murphy, P.A.-C.

• Physician Assistant in Rockwall, TX
• Providers in Rockwall, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2016; 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.