Active NPI
Mary Alice Pullen
- Physical Therapist
- Huntington, WV
National Provider Identifier
1629132295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 583
- Practice address
- 5170 U.S. Route 60 East
Huntington, WV 25705 - Phone
- (304) 399-2200
- NPI assigned
- Dec 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 583 | WV | Primary |
Addresses
Primary practice location
5170 U.S. Route 60 East
Huntington, WV 25705
Mailing address
1 N Williamsburg Dr
Barboursville, WV 25504-9412
Phone (304) 733-1666
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3810006340 | Medicaid | WV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 583 | WV | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629132295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 N WILLIAMSBURG DR",
"city": "BARBOURSVILLE",
"state": "WV",
"postal_code": "255049412",
"telephone_number": "304-733-1666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5170 U.S. ROUTE 60 EAST",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "25705",
"telephone_number": "304-399-2200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PULLEN",
"first_name": "MARY",
"middle_name": "ALICE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WV",
"license": "583",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810006340",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Huntington, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.