Jerry Lee Mullen, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

963 Issued in OK

Practice address

7101 NW Expressway
#130
Oklahoma City, OK 73132-1584

Phone

(405) 721-7450

Fax

(405) 721-7491

NPI assigned

Sep 16, 2006

Last updated

Nov 30, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Jerry L. Mullen, O.D., P.C.

  • Optometrist
  • Oklahoma City, OK
  • NPI 1285841601
  Medicare reassignment NPD Authorized official
• Kingfisher Family Eyecare

  • Optometrist
  • Kingfisher, OK
  • NPI 1528728797
  Medicare reassignment NPD
• Med Southwest, PLLC

  dba MyEyeDr.

  • Optometrist
  • Broken Bow, OK
  • NPI 1174089478
  Medicare reassignment NPD
• Med Southwest, PLLC

  dba MyEyeDr.

  • Optometrist
  • Tulsa, OK
  • NPI 1124798160
  NPD
• Med Southwest, PLLC

  • Optometrist
  • Oklahoma City, OK
  • NPI 1679440762
  NPD
• Gerald W. McMullin, O.D., Inc.

  • Optometrist
  • Kingfisher, OK
  • NPI 1265588602
  NPD (past)

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1619073749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7101 NW EXPRESSWAY",
            "address_2": "STE 130",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731321584",
            "telephone_number": "405-721-7450",
            "fax_number": "405-721-7491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7101 NW EXPRESSWAY",
            "address_2": "#130",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731321584",
            "telephone_number": "405-721-7450",
            "fax_number": "405-721-7491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "JERRY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00068003",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200083220A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200083220B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Oluwaseyi Akande Mulero
• Davina Darlene Mulhall
• Anoushka Suzy Mullasseril
• Paul Mathews Mullasseril, DDS
• Cortney Mullen, PHARMD
• Emilee Anne Mullendore, LMSW U/S
• Emma Geraldine Mullendore
• Greg Mullens, DPH
• Abby D Muller
• Peter Robinson Muller, MD

• Optometrist in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.