Active NPI
Stephen Dale Mulhollen
- Orthopedic Physical Therapist
- Greeneville, TN
National Provider Identifier
1578048245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- PT0000005810
- Practice address
- 2000 Monarch Pointe
Greeneville, TN 37745-3774 - Phone
- (423) 609-7997
- Fax
- (423) 609-7033
- NPI assigned
- Sep 28, 2018
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | PT0000005810 | TN | Primary |
Addresses
Primary practice location
2000 Monarch Pointe
Greeneville, TN 37745-3774
Mailing address
1414 Brentwood Dr
Greeneville, TN 37743-6609
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211203000476 | TN | Practitioner - Physical Therapist in Private Practice | 6709274012 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Journey Physical Therapy and Balance Center
Practice addresses (Care Compare)
2000 Monarch PT
Greeneville, TN 37745-4637
Phone (423) 609-7997
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT0000005810 | TN | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Journey Physical Therapy & Balance Center | Orthopedic | Current | Accepting new patients |
Locations
2000 Monarch Pt
Greeneville, TN 37745
Phone (423) 218-2656
Organizations & group practices 1
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.
-
- Physical Therapist
- Greeneville, TN
- NPI 1275206336
Orthopedic, TN
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638403200000",
"number": "1578048245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1414 BRENTWOOD DR",
"city": "GREENEVILLE",
"state": "TN",
"postal_code": "377436609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 MONARCH POINTE",
"city": "GREENEVILLE",
"state": "TN",
"postal_code": "377453774",
"telephone_number": "423-609-7997",
"fax_number": "423-609-7033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULHOLLEN",
"first_name": "STEPHEN",
"middle_name": "DALE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-28",
"last_updated": "2021-12-02",
"certification_date": "2021-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "TN",
"license": "PT0000005810",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Greeneville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.