Active NPI
Jade Riley Violet Mullin
- Homemaker
- Clearwater, FL
National Provider Identifier
1669934709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Homemaker
- License
- 234948
- Practice address
- 2114 Drew St Ste a
Clearwater, FL 33765-3216 - Phone
- (727) 687-8617
- NPI assigned
- Apr 5, 2019
- 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 |
|---|---|---|---|---|
| Homemaker | 376J00000X | 234948 | FL | Primary |
Addresses
Primary practice location
2114 Drew St Ste a
Clearwater, FL 33765-3216
Mailing address
2114 Drew St Ste a
Clearwater, FL 33765-3216
Phone (727) 687-8617
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 |
|---|---|---|---|
| 234948 | FL | MD | Homemaker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1669934709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2114 DREW ST STE A",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337653216",
"telephone_number": "727-687-8617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2114 DREW ST STE A",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337653216",
"telephone_number": "727-687-8617"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLIN",
"first_name": "JADE",
"middle_name": "RILEY VIOLET",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-04-05",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": "FL",
"license": "234948",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clearwater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.