Individual provider Active NPI

Adam Mullet, MD

  • Psychiatry Physician
  • Roanoke, VA
National Provider Identifier
1609492594
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0101280463 Issued in VA
Practice address
2130 Rosalind Ave SW
Roanoke, VA 24014-1718
Phone
(540) 589-7807
NPI assigned
Jun 17, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0101280463 VA Primary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 84567 SC

Addresses

Primary practice location

2130 Rosalind Ave SW
Roanoke, VA 24014-1718

Mailing address

96 Jonathan Lucas St Ste 601
Charleston, SC 29425-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240506003845 VA Practitioner - Psychiatry 3375962319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Eastern Virginia Medical School, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Geropsychiatry LLCGroup PAC ID 7911257183, 2 clinicians

Practice addresses (Care Compare)

2123 B Crystal Spring Ave SW
Roanoke, VA 24014-2413
Phone (540) 266-3136

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
84567SCMDPsychiatry Physician
0101280463VAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Geropsychiatry LLC Single Specialty CurrentSince Jun 15, 2024 Accepting new patients
The Wellness Connection Past Accepting new patients

Locations

2123 Crystal Spring Ave SW
Ste B
Roanoke, VA 24014
Phone (540) 266-3136

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1609492594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 JONATHAN LUCAS ST STE 601",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 ROSALIND AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141718",
            "telephone_number": "540-589-7807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLET",
        "first_name": "ADAM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-17",
        "last_updated": "2024-05-14",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101280463",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "84567",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.