Active NPI
Wesley S Mullen Jr., D.C.
- Chiropractor
- Mountain Top, PA
National Provider Identifier
1568527034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC001393L
- Practice address
- 34 N Mountain Blvd
Mountain Top, PA 18707-1117 - Phone
- (570) 474-5042
- Fax
- (570) 474-5222
- NPI assigned
- Dec 26, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC001393L | PA | Primary |
Addresses
Primary practice location
34 N Mountain Blvd
Mountain Top, PA 18707-1117
Mailing address
34 N Mountain Blvd
Mountain Top, PA 18707-1117
Phone (570) 474-5042
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 350925065 | Other | PA | PALMETTO RAILROAD MEDICAR |
| 0006143120001 | Medicaid | PA |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1568527034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 N MOUNTAIN BLVD",
"city": "MOUNTAIN TOP",
"state": "PA",
"postal_code": "187071117",
"telephone_number": "570-474-5042",
"fax_number": "570-474-5222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34 N MOUNTAIN BLVD",
"city": "MOUNTAIN TOP",
"state": "PA",
"postal_code": "187071117",
"telephone_number": "570-474-5042",
"fax_number": "570-474-5222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLEN",
"first_name": "WESLEY",
"middle_name": "S",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "PA",
"license": "DC001393L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO RAILROAD MEDICAR",
"identifier": "350925065",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0006143120001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mountain Top, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.