Mary Patricia Mullin, DNP, FNP-BC, RN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704190831 Issued in MI

Practice address

250 Monroe Ave NW Ste 400
Grand Rapids, MI 49503-2293

Phone

(248) 444-4720

NPI assigned

Jul 10, 2008

Last updated

Oct 13, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 1996

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Interoperability endpoints

• Direct secure messaging: mmullin20798@carelonhealth.direct-ci.com
• Direct secure messaging: mmullin716751@direct.hfhs.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Carelon Medical Partners, PC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Nashville, TN
  • NPI 1124443403

  WI

  Medicare reassignment

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1598929473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21535 SUMMERSIDE LN",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481671055",
            "telephone_number": "248-444-4720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 MONROE AVE NW STE 400",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032293",
            "telephone_number": "248-444-4720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIN",
        "first_name": "MARY",
        "middle_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-BC, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704190831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christian Henry Mullett, L.AC
• Shannon M Mullett, LMSW, CAADC
• Crystal Mulligan
• Deborah Kayteen Mulligan, DO
• Emiel Murphy Mulligan
• Marianne Mullins-Macritchie
• Anthony Mullins
• Justin Mullins
• Alison Mulrenin
• Kaitlin Mulvihill, LLMSW, MTBC

• Family Nurse Practitioner in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.