Individual provider Active NPI

Jessica Mullis, NP-C

  • Adult Health Nurse Practitioner
  • Chapel Hill, NC
National Provider Identifier
1528492733
Registry record updated Jul 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
227599 Issued in NC
Practice address
101 Manning Dr
Chapel Hill, NC 27514-4220
Phone
(919) 966-4131
NPI assigned
Aug 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 227599 NC Primary

Addresses

Primary practice location

101 Manning Dr
Chapel Hill, NC 27514-4220

Mailing address

5121 Copper Ridge Dr
204
Durham, NC 27707-5589
Phone (919) 667-4729

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140107000225 NC Practitioner - Nurse Practitioner 1254569825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 Manning Dr
Chapel Hill, NC 27514-4220
Phone (984) 974-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
227599NCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Carolina at Chapel Hill CurrentSince Oct 15, 2013 Accepting new patients
Park Ophthalmology Past Accepting new patients

Locations

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

Interoperability endpoints

  • Direct secure messaging: jedwards15376@direct.unc.nchie.net

Organizations & group practices 2

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": "1377216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1528492733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5121 COPPER RIDGE DR",
            "address_2": "204",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277075589",
            "telephone_number": "919-667-4729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MANNING DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275144220",
            "telephone_number": "919-966-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIS",
        "first_name": "JESSICA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-23",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "227599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.