Active NPI
Tina Marie Mulcahy
- Registered Nurse
- Martinsburg, WV
National Provider Identifier
1548445083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 47011
- Practice address
- 2001 S Queen St
Martinsburg, WV 25401 - Phone
- (304) 267-3500
- NPI assigned
- Jan 3, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 47011 | WV | Primary |
Addresses
Primary practice location
2001 S Queen St
Martinsburg, WV 25401
Mailing address
112 Deep Woods Trail
Shepherdstown, WV 25443
Phone (304) 876-9262
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3810010335 | Medicaid | WV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47011 | WV | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199318400000",
"number": "1548445083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "112 DEEP WOODS TRAIL",
"city": "SHEPHERDSTOWN",
"state": "WV",
"postal_code": "25443",
"telephone_number": "304-876-9262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2001 S QUEEN ST",
"city": "MARTINSBURG",
"state": "WV",
"postal_code": "25401",
"telephone_number": "304-267-3500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULCAHY",
"first_name": "TINA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-03",
"last_updated": "2008-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WV",
"license": "47011",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810010335",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Martinsburg, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.