Kathryn L McMullan, M.D.

Primary specialty

Allergy PhysicianTaxonomy code 207KA0200X

License

M8497 Issued in ID

Practice address

323 E Riverside Dr
Ste 234
Eagle, ID 83616-6864

Phone

(208) 938-4080

Fax

(208) 938-8922

NPI assigned

Jun 6, 2006

Sex

Female

Sole proprietor

Yes

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 WI, CO2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  CO, WI

  Medicare reassignment NPD

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263945600000",
    "number": "1538108089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 E RIVERSIDE DR",
            "address_2": "STE 234",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166864",
            "telephone_number": "208-938-4080",
            "fax_number": "208-938-8922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 E RIVERSIDE DR",
            "address_2": "STE 234",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166864",
            "telephone_number": "208-938-4080",
            "fax_number": "208-938-8922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMULLAN",
        "first_name": "KATHRYN",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2010-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "ID",
            "license": "M8497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John David McDermott, P.A.
• Laura Michelle McDermott, M.D.
• James Donald McGregor, MD
• Alan Wallace McInnes Jr., M.D.
• Kylee A McManus
• Jennifer McWaters, PSY.D.
• Mederx, LLC
• Medical Fitness Center LLC
• Mednow Inc (MedNow Eagle Pharmacy)
• Megan Meduna, MSPT

• Allergy Physician in Eagle, ID
• Providers in Eagle, ID by specialty
• Allergy Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.