Connor Daniel Mullan, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

8279 Issued in SC

Practice address

2005 E Greenville St
Suite 119
Anderson, SC 29621-1575

Phone

(864) 964-0505

Fax

(864) 222-0182

NPI assigned

Jul 8, 2016

Last updated

Aug 1, 2016By the provider in NPPES

Sex

Male

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 SC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Elite Integrated Therapy Centers, LLC

  • Physical Therapist
  • Greenville, SC
  • NPI 1184673600
  Medicare reassignment NPD

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

{
    "created_epoch": "1467936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470009600000",
    "number": "1538511092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 GROVE RD",
            "address_2": "SUITE 2-A",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054660",
            "telephone_number": "864-233-5128",
            "fax_number": "864-271-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 E GREENVILLE ST",
            "address_2": "SUITE 119",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296211575",
            "telephone_number": "864-964-0505",
            "fax_number": "864-222-0182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLAN",
        "first_name": "CONNOR",
        "middle_name": "DANIEL",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-08",
        "last_updated": "2016-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "8279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Andrew Mowlajko, D.M.D.
• Mowlajlo Family and Cosmetic Dentistry,LLC
• MP Veera MD PA
• John Muhonen II
• Debra Ann Mull, RN, BHSR, MBA
• Mary Beth K Mullaney, MS. CCC.SLP
• Morgan Louise Mullenix, RBT
• Diana Mullikin, FNP-C
• Jessica Ann Mullis, FNP
• Brian James Mulroy, D.O.

• Physical Therapist in Anderson, SC
• Providers in Anderson, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.