Individual provider Active NPI

Julie Leigh Mullen, D.O.

  • Family Medicine Physician
  • Woodbridge, VA
National Provider Identifier
1639226723
Registry record updated Jun 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0102201506 Issued in VA
Practice address
14139 Potomac Mills Rd
Kaiser Permanente Woodbridge Medical Center
Woodbridge, VA 22192-4644
Phone
(703) 490-8400
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0102201506 VA Primary

Addresses

Primary practice location

14139 Potomac Mills Rd
Kaiser Permanente Woodbridge Medical Center
Woodbridge, VA 22192-4644

Mailing address

2101 E Jefferson St
Kaiser Permanente Medicare Enrollment
Rockville, MD 20852-4908
Phone (301) 816-2424

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040519001164 DC Practitioner - Family Practice 7113918152 Reassigns benefits to 1 organization
I20101014001407 VA Practitioner - Family Practice 7113918152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1221 Mercantile LN
Largo, MD 20774-5374
Phone (301) 618-5700

13285 Minnieville Rd
Woodbridge, VA 22192-4018
Phone (703) 986-2400

14139 Potomac Mills Rd
Woodbridge, VA 22192-4644
Phone (703) 257-3000

1890 Metro Ctr Dr
Reston, VA 20190-5286
Phone (703) 709-1500

8008 Westpark Dr
MC Lean, VA 22102-3109
Phone (703) 287-6400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102201506VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Oct 1, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Family Medicine CurrentSince Jun 28, 2010 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Family Medicine Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Jun 28, 2010 Accepting new patients

Locations

2101 E Jefferson St
Rockville, MD 20852
Phone (301) 816-6660

2101 E Jefferson St
Ste 4E
Rockville, MD 20852
Phone (301) 816-7405

2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853

2101 E Jefferson St
Ste 4EAST
Rockville, MD 20852

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

12011 Route 50
Fairfax, VA 22033
Phone (703) 383-5400

14139 Potomac Mills Rd
Woodbridge, VA 22192
Phone (703) 257-3000

Organizations & group practices 4

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624147200000",
    "number": "1639226723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 E JEFFERSON ST",
            "address_2": "KAISER PERMANENTE MEDICARE ENROLLMENT",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524908",
            "telephone_number": "301-816-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14139 POTOMAC MILLS RD",
            "address_2": "KAISER PERMANENTE WOODBRIDGE MEDICAL CENTER",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924644",
            "telephone_number": "703-490-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "JULIE",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2021-06-20",
        "certification_date": "2021-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102201506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "14139 Potomac Mills Rd",
            "address_2": "Kaiser Permanente Woodbridge Medical Center",
            "city": "Woodbridge",
            "state": "VA",
            "country_code": "US",
            "postal_code": "221924644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.