Active NPI
Mark McMullan, OTR
- Occupational Therapist
- Olympia, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT-3029
- Practice address
- 700 Lilly Rd NE
Olympia, WA 98506-5115 - Phone
- (360) 923-7000
- Fax
- (360) 923-7089
- NPI assigned
- Nov 1, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 22059 | FL | |
| Occupational Therapist | 225X00000X | OT-3029 | NV | Primary |
Addresses
Primary practice location
700 Lilly Rd NE
Olympia, WA 98506-5115
Mailing address
325 Hanson St
Winnemucca, NV 89445-3607
Phone (775) 625-2222
Other practice location 1
301 S Myrtle Ave
New Smyrna Beach, FL 32168-6900
Phone (386) 410-2523
Other practice location 2
901 Vista Trelago
Maitland, FL 32751
Phone (407) 388-4477
Other practice location 3
325 Hanson St
Winnemucca, NV 89445-3607
Phone (775) 625-2222
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
700 Lilly Rd NE
Olympia, WA 98506-5115
Phone (360) 923-7000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22059 | FL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients |
Locations
700 Lilly Rd NE
Olympia, WA 98506
Phone (360) 923-7000
200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530
9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800
Interoperability endpoints
- mmcmullan4265876@ghc.direct-ci.net
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Seattle, WA
- NPI 1396810701
-
- Multi-Specialty Clinic/Center
- Renton, WA
- NPI 1124264577
-
- Multi-Specialty Clinic/Center
- Everett, WA
- NPI 1386935351
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693180800000",
"number": "1588329973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 HANSON ST",
"city": "WINNEMUCCA",
"state": "NV",
"postal_code": "894453607",
"telephone_number": "775-625-2222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 LILLY RD NE",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985065115",
"telephone_number": "360-923-7000",
"fax_number": "360-923-7089"
}
],
"practiceLocations": [
{
"address_1": "301 S Myrtle Ave",
"address_purpose": "LOCATION",
"city": "New Smyrna Beach",
"state": "FL",
"postal_code": "321686900",
"country_code": "US",
"telephone_number": "386-410-2523",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "901 Vista Trelago",
"address_purpose": "LOCATION",
"city": "Maitland",
"state": "FL",
"postal_code": "32751",
"country_code": "US",
"telephone_number": "407-388-4477",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "325 Hanson St",
"address_purpose": "LOCATION",
"city": "Winnemucca",
"state": "NV",
"postal_code": "894453607",
"country_code": "US",
"telephone_number": "775-625-2222",
"fax_number": "775-625-1131",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCMULLAN",
"first_name": "MARK",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-11-01",
"last_updated": "2023-08-28",
"certification_date": "2023-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "22059",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NV",
"license": "OT-3029",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "700 Lilly Rd NE",
"city": "Olympia",
"state": "WA",
"country_code": "US",
"postal_code": "985065115",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.