Joseph Bradley Mulligan, LDO

Primary specialty

OpticianTaxonomy code 156FX1800X

License

111891 Issued in KY

Practice address

1015 New Moody LN
La Grange, KY 40031-9142

Phone

(502) 222-5292

Fax

(502) 222-5274

NPI assigned

Jun 15, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1655251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1558091173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 ALTON RD",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400651447",
            "telephone_number": "859-230-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 NEW MOODY LN",
            "city": "LA GRANGE",
            "state": "KY",
            "postal_code": "400319142",
            "telephone_number": "502-222-5292",
            "fax_number": "502-222-5274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIGAN",
        "first_name": "JOSEPH",
        "middle_name": "BRADLEY",
        "credential": "LDO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-15",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "CA",
            "license": "SLD41354",
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "CA",
            "license": "CLD8386",
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "KY",
            "license": "111891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haley Natalya Morgan
• Tori Moses
• Lydia Grace Moss, PA
• Linda Mudd
• Deanna Lynn Mueller, P.A.-C
• Brittany Paige Mullins, COTA/L
• April Dawn Munson
• Jennifer Murphy
• Jennifer Murphy, LPCC-S
• Steffany Nicole Neie, RPH

• Optician in La Grange, KY
• Providers in La Grange, KY by specialty
• Optician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.